Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy

Borel, Frédéric; Delemazure, A.S.; Espitalier, F.; Spiers, Andrew; Mirallié, Éric; Blanchard, Claire

doi:10.1007/s00268-015-3393-x

Cited by 34 publications

(53 citation statements)

References 37 publications

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“…The physiological variations in VFDV with age and gender have been explained by an increase in fibrous tissue and shorter length of VF in females respectively . while pathological decrease occurs in association with RLN involvement (neuropraxia or compression effect) …”

Section: Discussionmentioning

confidence: 99%

“…Quantitative variables were compared by Mann‐Whitney U Test while the strength of association was assessed by Spearman's rank correlation test. Presence of hoarseness, age, gender and weight have reported and biologically plausible effect on VFDV of vocal fold movement …”

Section: Methodsmentioning

confidence: 99%

“…Flexible laryngoscopy (FL) for visualisation of vocal folds (VF) in patients undergoing thyroidectomy is an unpleasant experience for patients even with good topical anaesthesia …”

Section: Introductionmentioning

confidence: 99%

“…However, universal acceptance is still lacking due to variable reported diagnostic sensitivity and specificity to distinguish disabled VFs. In most studies, TCLUS has been performed by otolaryngologists, endocrine surgeons, or radiologist, but none by the anaesthesiologist. Although anaesthesiologists have been performing airway ultrasound for assessing difficult airway, measurement of tracheal diameter for selection of the appropriate size of double lumen tube, identifying cricothyroid membrane for surgical securement of airway but functional analysis of VF by TCLUS is relatively unexplored.…”

Section: Introductionmentioning

confidence: 99%

“…Transcutaneous laryngeal ultrasound can assess functionality of VFs by evaluating mobility of true or false VFs subjectively or by quantification of vocal fold displacement velocity (VFDV) . Neither technique has proven superiority over the other for reliable identification of disabled VF.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy

Dubey

Mittal

Jaipuria

et al. 2018

Acta Anaesthesiol Scand

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Provided achievement of optimal acoustic window, TCLUS can reliably assess disabled VFs with FL reserved for their confirmation or doubtful cases. Subjective assessment of VF mobility should suffice in most cases with additional VFDV estimation reserved pre-operatively for situations with higher risk of VFs disability, and post-operatively when subjective VF assessment findings are discordant from pre-operative status.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Flexible laryngoscopy (FL) for visualisation of vocal folds (VF) in patients undergoing thyroidectomy is an unpleasant experience for patients even with good topical anaesthesia …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy

Dubey

Mittal

Jaipuria

et al. 2018

Acta Anaesthesiol Scand

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Laryngeal Ultrasound Detects Vocal Fold Immobility in Adults

Hamilton

Tawfik

et al. 2021

J of Ultrasound Medicine

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Laryngeal ultrasound (US) is becoming widely accepted for assessing true vocal fold immobility (TVFI), a potential complication of laryngeal and thyroid surgery. The objective of this project is to perform a systematic review and meta‐analysis of pooled evidence surrounding laryngeal US as a modality for diagnosing TVFI in adults at risk for the condition in comparison to laryngoscopy as a gold standard. Medical subject heading terms were used to search MEDLINE, Embase, Google Scholar, Web of Science, and the Cochrane Library for relevant citations from January 1, 2000, to June 30, 2020. Studies were included if they involved patients 16 years and older, where laryngeal US was compared to laryngoscopy for TVFI. Studies were excluded if there were insufficient data to compute a sensitivity/specificity table after attempting to contact the authors. Case reports, and case series were also excluded. The initial search returned 1357 citations. Of these, 109 were selected for review utilizing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Thirty citations describing 6033 patients were included in the final meta‐analysis. A bivariate random effects meta‐analysis was performed, revealing a pooled sensitivity for laryngeal US of 0.95 (95% confidence interval [CI] 0.88–0.98), a specificity of 0.99 (95% CI 0.97–0.99), and a diagnostic odds ratio of 1328.2 (95% CI 294.0–5996.5). The area under the curve of the hierarchical summary receiver operating characteristic curve was 0.99 (95% CI 0.98–1.00). Laryngeal US demonstrates high sensitivity and specificity for detecting VFI in the hands of clinicians directly providing care to patients.

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A Novel Lateral Approach to the Assessment of Vocal Cord Movement by Ultrasonography

et al. 2017

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BackgroundUltrasonography is a non-invasive technique that is commonly used by endocrinologists and endocrine surgeons to examine the thyroid region and could be useful for the assessment of vocal cord movement by these specialists. However, previous studies reported a low rate of successful visualization of vocal cord movement by ultrasonography. To address this issue, we devised a novel ultrasonographic procedure for assessing vocal cord movement indirectly by observing the arytenoid movement from a lateral view.MethodsSubjects were 188 individuals, including 23 patients with vocal cord paralysis and 13 with vocal cord paresis. We performed ultrasonographic assessment of vocal cord movement using two different procedures: the conventional middle transverse procedure and the novel lateral vertical procedure.ResultsThe rate of visualization of vocal cords with the middle transverse procedure was 70.2% and that of the arytenoid cartilage with the lateral vertical procedure was 98.4%. The lateral vertical procedure enabled visualization of all patients with vocal cord paresis/paralysis and detected all 23 patients with vocal paralysis; only one of 13 patients with vocal cord paresis was positively identified. The conventional procedure enabled visualization of 21 of 36 patients with vocal cord paresis/paralysis with high accuracy. There was no false-positive case in either procedure.ConclusionThe proposed lateral vertical procedure improved the rate of visualization of vocal cord movement by ultrasonography, suggesting that it is a useful technique to screen for vocal cord paralysis by ultrasonography.Electronic supplementary materialThe online version of this article (doi:10.1007/s00268-017-4151-z) contains supplementary material, which is available to authorized users.

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Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy

Abstract: TLUS sensitivity is insufficient in early postoperative screening of VCP after thyroid surgery. Ultrasonographic VCP diagnosis should be confirmed with DFL.

Cited by 34 publications

References 37 publications

Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy

Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy

Laryngeal Ultrasound Detects Vocal Fold Immobility in Adults

A Novel Lateral Approach to the Assessment of Vocal Cord Movement by Ultrasonography

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