航空医学评估和成功返回飞行的军事飞行员舌甲状腺:病例报告和随访。

IF 3.3 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Pangmin Li, Liangchen Wang, Li Xiao, Lin Ding, Dandan Wang, Caizhe Yang, Di Zhu
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引用次数: 0

摘要

背景:舌甲状腺是一种罕见的先天性异常,由胚胎发育期间甲状腺组织的异常迁移引起。虽然经常无症状,但鉴于严格的航空医学认证标准,在军事机组人员中进行识别提出了特别的挑战。病例介绍:一名37岁男性军用直升机飞行员在常规健康检查中偶然被诊断为舌甲状腺。患者在整个临床过程中均无症状。综合评估——包括甲状腺功能检查、生化分析、宫颈磁共振成像、电子喉镜检查、放射性核素扫描和便携式睡眠监测——证实了亚临床甲状腺功能减退的存在。影像学显示舌底异位组织为唯一功能正常的甲状腺。左旋甲状腺素治疗开始,导致甲状腺激素水平正常化。由于病变的解剖位置,排除阻塞性睡眠呼吸暂停或通气障碍,进行了多导睡眠图检查。鉴于患者有强烈的恢复飞行职责的动机,进行了多学科航空医学评估。根据临床稳定性、无症状和治疗反应,该飞行员被认为符合航空医学要求。自2021年6月以来,他累计飞行900多个小时,甲状腺功能完好,纵向随访无疾病进展迹象。结论:据我们所知,这是中国第一个记录在案的有舌甲状腺的军事飞行员成功认证继续飞行任务的案例。本病例提示先天性内分泌异常在某些病例中可能与高要求的职业角色相容,有待全面的个人评估和基于风险的航空医学评估。它还支持在航空医学方面采用风险分层、非侵入性管理模式,这对加强飞行安全和人员保留都有影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Aeromedical evaluation and successful return to flight in a military pilot with lingual thyroid: a case report and follow-up.

Background: Lingual thyroid is a rare congenital anomaly resulting from the aberrant migration of thyroid tissue during embryonic development. Although frequently asymptomatic, its identification in military aircrew poses particular challenges given the rigorous standards of aeromedical certification.

Case presentation: A 37-year-old male military helicopter pilot was incidentally diagnosed with lingual thyroid during routine health screening. The patient remained asymptomatic throughout the clinical course. Comprehensive evaluations-including thyroid function tests, biochemical profiling, cervical magnetic resonance imaging, electronic laryngoscopy, radionuclide scanning, and portable sleep monitoring-confirmed the presence of a lingual thyroid with subclinical hypothyroidism. Imaging demonstrated the ectopic tissue at the tongue base to be the sole functioning thyroid gland. Levothyroxine therapy was initiated, resulting in normalization of thyroid hormone levels. Polysomnography was performed due to the anatomical location of the lesion and excluded obstructive sleep apnea or ventilatory compromise. Given the patient's strong motivation to resume flight duties, a multidisciplinary aeromedical evaluation was conducted. Based on clinical stability, absence of symptoms, and treatment response, the pilot was deemed aeromedically fit. Since June 2021, he has accumulated over 900 flight hours, with preserved thyroid function and no evidence of disease progression on longitudinal follow-up.

Conclusions: To the best of our knowledge, this represents the first documented case in China of a military pilot with lingual thyroid successfully certified for continued flying duties. This case suggests that congenital endocrine anomalies may be compatible with high-demand occupational roles in select cases, pending comprehensive individual evaluation and risk-based aeromedical assessment. It further supports the adoption of a risk-stratified, non-invasive management paradigm in aviation medicine, with implications for enhancing both flight safety and personnel retention.

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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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