Point-of-Care Ultrasound of the Head and Neck in Children

Lambert, Elton M.; Barbot, Chantal; Tran, Huy; Ongkasuwan, Julina

doi:10.1007/s40136-022-00419-0

Cited by 3 publications

(2 citation statements)

References 62 publications

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“…Similarly, laryngoscopy combined with LUS is likely to clarify a diagnosis of suspected VFI compared to a single investigation. LUS has also been shown to be easy to learn for clinicians other than otolaryngologists (15,16,(19)(20)(21)(22), suggesting it may be a useful tool in remote areas where an otolaryngologist may not be available.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal ultrasound for evaluation of paediatric unilateral vocal fold immobility -- a retrospective cohort study in Aotearoa New Zealand and a survey of clinicians around the world

Marinone,

Mackay,

Clark

et al. 2024

Preprint

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Objective: Vocal fold immobility (VFI) is a cause of significant morbidity and mortality in the paediatric population. Laryngoscopy is the current first-line investigation for patients with suspected VFI. Laryngeal ultrasound (LUS) has recently emerged as an alternative method of identifying VFI. Compared to laryngoscopy, LUS is less invasive, does not require anaesthesia, and can be performed by non-otolaryngologists. The primary objective of this study is to evaluate LUS as a diagnostic method for the identification of unilateral VFI in a cohort of paediatric patients in Aotearoa New Zealand (NZ). The secondary objective is to estimate the frequency of use of LUS in the paediatric population around the world. Methods: A retrospective, single-centre cohort study was performed on all paediatric patients who had undergone laryngoscopy and LUS at Starship Children’s Health between 2020 to 2023 in Auckland, NZ. An eight-question survey was also developed and distributed to better understand clinicians’ use of LUS to diagnose paediatric VFI globally. Results: Twenty-three paediatric patients met the inclusion criteria. LUS demonstrated high sensitivity (100%), specificity (63%), positive predictive value (83%), and negative predictive value (100%) for detecting unilateral VFI within our patient population. Out of the eighty-seven respondents to the survey, nearly half utilise LUS in their clinical practice in the paediatric population. The main barrier for those who do not is lack of expertise, equipment, and training. Conclusions: These findings support the use of LUS as a safe and accurate diagnostic tool for the detection of unilateral VFI. Further studies in non-surgical populations and standardised guidelines for LUS technique and reporting are required.

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Section: Discussionmentioning

confidence: 99%

Laryngeal ultrasound for evaluation of paediatric unilateral vocal fold immobility -- a retrospective cohort study in Aotearoa New Zealand and a survey of clinicians around the world

Marinone,

Mackay,

Clark

et al. 2024

Preprint

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“…In a recent review, POCUS-guided BTX-A application in salivary glands was highlighted as a technique suggested by most experts for the treatment of anterior sialorrhea in the pediatric population [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guidance Superiority in Pediatric Sialorrhea Treatment With Intraglandular Botulinum Toxin Application: A Four-Year Retrospective Study

Pires,

Saldanha,

Claro

2023

Cureus

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Introduction The management of sialorrhea in children with multiple disabilities is extremely important not only for aesthetic/psychosocial reasons but also for functional and clinical ones. There are several recommended management methods with strong evidence of the effectiveness of intraglandular application of botulinum toxin A. Materials and methods In this four-year retrospective report, we compare two populations who received intraglandular type A botulinum toxin injections in the pediatric unit of the Physical Medicine and Rehabilitation (PM&R) Department at a central hospital. The injections were administered using either ultrasound guidance (US) or anatomical landmarks. Results Out of a total of 29 patients with neurological conditions, 16 met the eligibility criteria for this study. The study group comprised seven females (44%) and nine males (56%), with a median age of 9 years. The average pre-procedure sialorrhea staging was four. A total of 23 procedures were performed, with 16 conducted under ultrasound guidance (US) and seven via anatomical landmarks (non-US). In the US group, a statistically significant difference in sialorrhea staging was observed at one and three months post-procedure (p<0.05), but not at six months post-procedure. Conversely, no statistically significant difference in sialorrhea staging was found at any time point in the non-US group. The comparison between the two groups supports the use of ultrasound guidance, showing superior outcomes at one and three months post-procedure (p<0.05). Conclusion The results of this study align with global trends seen in medical publications and guidelines advocating for the use of ultrasound in this procedure. Future prospective and larger-scale studies are essential to validate these findings.

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Paediatric Laryngeal Ultrasound: A Retrospective Cohort Study in Aotearoa New Zealand and an International Survey

Marinone Lares,

Mackay,

Clark

et al. 2024

Clinical Otolaryngology

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ObjectiveVocal fold immobility (VFI) is a cause of significant morbidity and mortality in the paediatric population. Laryngoscopy is the current first‐line investigation for patients with suspected VFI. Laryngeal ultrasound (LUS) has recently emerged as an alternative method of identifying VFI. Compared to laryngoscopy, LUS is less invasive, does not require anaesthesia, and can be performed by non‐otolaryngologists. The objectives of this study are to evaluate LUS as a diagnostic method for the identification of VFI in a cohort of paediatric patients in Aotearoa New Zealand (NZ) and to estimate the frequency of use of LUS in the paediatric population by clinicians around the world.MethodsA retrospective, single‐centre cohort study was performed on all paediatric patients who had undergone laryngoscopy and LUS at Starship Children's Health in Auckland, NZ, between 2020 and 2023. An eight‐question survey was also developed and distributed to better understand clinicians' use of LUS in their clinical practice to diagnose paediatric VFI globally.ResultsTwenty‐nine paediatric patients met the inclusion criteria. LUS demonstrated good sensitivity (80.95%) for detecting VFI and increased to 93.33% for the detection of unilateral VFI. Of the 87 respondents to the survey, 41.38% utilise LUS in their clinical practice in the paediatric population. The main barriers to implementation of LUS as identified by non‐users were lack of equipment, expertise, and training.ConclusionsThese findings support the use of LUS as an accurate diagnostic tool for the detection of unilateral VFI. Further studies in non‐surgical populations and in patients with bilateral VFI, as well as standardised guidelines for LUS technique and reporting, are required.

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Point-of-Care Ultrasound of the Head and Neck in Children

Cited by 3 publications

References 62 publications

Laryngeal ultrasound for evaluation of paediatric unilateral vocal fold immobility -- a retrospective cohort study in Aotearoa New Zealand and a survey of clinicians around the world

Laryngeal ultrasound for evaluation of paediatric unilateral vocal fold immobility -- a retrospective cohort study in Aotearoa New Zealand and a survey of clinicians around the world

Ultrasound Guidance Superiority in Pediatric Sialorrhea Treatment With Intraglandular Botulinum Toxin Application: A Four-Year Retrospective Study

Paediatric Laryngeal Ultrasound: A Retrospective Cohort Study in Aotearoa New Zealand and an International Survey

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