A novel lateral-approach laryngeal ultrasonography for vocal cord evaluation

• Published in: Surgery Vol. 159; no. 1; pp. 52 - 57
• Main Authors: Woo, Jung-Woo, MD, Suh, Hyunsuk, MD, Song, Ra-Yeong, MD, Lee, Joon-Hyop, MD, Yu, Hyeong Won, MD, Kim, Su-jin, MD, PhD, Chai, Young Jun, MD, Choi, June Young, MD, Lee, Kyu Eun, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2016
• Subjects: Adult; Aged; Female; Humans; Laryngoscopy; Larynx - diagnostic imaging; Male; Middle Aged; Parathyroidectomy - adverse effects; Preoperative Care; Risk Assessment; Surgery; Thyroidectomy - adverse effects; Ultrasonography; Vocal Cord Paralysis - diagnosis; Vocal Cord Paralysis - etiology; Vocal Cord Paralysis - prevention & control; Vocal Cords - diagnostic imaging; Vocal Cords - physiology; Young Adult
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2015.07.043

Background Laryngeal ultrasonography (LUS) is a new method of vocal cord (VC) evaluation in patients with risk of vocal cord palsy (VCP). The previously described anterior-approach LUS reportedly, however, has high failure rate of VC visualization in male patients. We devised a novel lateral-approach LUS to overcome this limitation. Methods A total of 382 (82 male, 300 female) consecutive LUS and direct laryngoscopy (DL) examinations were performed on perioperative thyroidectomy and parathyroidectomy patients. The anterior-approach LUS was used for female patients whereas the lateral-approach LUS was used for male patients. Findings were cross-validated independently with DL examinations. Results Both anterior and lateral LUS methods had 100% visualization rate (no failed visualization) with an overall sensitivity of 100% (23/23) and specificity of 99.2% (356/359) for VCP. Among the 300 female patients, 18 patients had VCP. Sensitivity and specificity of anterior-approach LUS were 100% (18/18) and 99.3% (280/282), respectively. Among the 80 male patients, 5 patients had VCP. Sensitivity and specificity of lateral-approach LU were 100% (5/5) and 98.7% (76/77), respectively. Conclusion The new LUS approach significantly enhances the visualization of vocal cords and, therefore, overall diagnostic efficacy of LUS in male patients.