Feasibility and accuracy of laryngeal ultrasound for the assessment of vocal cord mobility in children

Comparison of the diagnostic and prognostic abilities of flexible laryngoscopy and dynamic digital radiography for vocal cord paralysis: A prospective observational study

BACKGROUND

Although flexible laryngoscopy (FL) is the reference modality for diagnosing vocal cord paralysis (VCP), FL involves patient discomfort and insertion intolerance. Dynamic digital radiography (DDR) with high spatial and temporal resolution is easier to use and less invasive when evaluating VCP.

METHODS

Seventy-eight patients underwent FL and DDR before and after neck surgery. Qualitative and quantitative vocal cord movement (VCM) evaluations were conducted. Patients with postoperative VCP were followed-up regularly.

RESULTS

DDR exhibited diagnostic performance with 67% sensitivity and 100% specificity. The cutoff for VCM was 2.4 mm, with DDR exhibiting 100% sensitivity and 78% specificity. All cords with transient VCP had positive VCM at both 3 weeks and 2 months. Additionally, 50% and 75% of cords with permanent VCP had negative VCM at 3 weeks and 2 months, respectively.

CONCLUSIONS

DDR is promising for the diagnosis of postoperative VCP and early prediction of permanent postoperative VCP.

Can Transcutaneous Laryngeal Ultrasonography Systematically Quantify Vocal Fold Movement?-A Feasibility Study

OBJECTIVES

Several studies have assessed adult vocal fold movement using transcutaneous laryngeal ultrasonography (TLUSG) during the perioperative period of thyroidectomy. However, the movement was not objectively quantified. This study aimed to provide a feasible and objective method for assessing vocal fold movement using TLUSG.

STUDY DESIGN

Feasibility study.

METHODS

TLUSG was performed during calm breathing and breath-holding in healthy adult volunteers. The morphology and anatomy of the larynx were observed and measured using an ultrasonic self-contained measurement function. At the end of the calm inspiratory and breath-holding phases, vocal fold angle, vocal fold length, distance from vocal process to the midline, distance from anterior vocal commissure to arytenoid cartilage, distance from false vocal fold to the midline, and distance from the anterior horn of thyroid cartilage to false vocal fold were measured. Data were analyzed using a t test (significance <0.05).

RESULTS

The ultrasonic images were satisfactory in all 40 healthy adult volunteers (age 19-35 years; body mass index 18.55-23.93 kg/m2; 20 men and 20 women). There were no significant differences in all laryngeal parameters between the left and right sides in both phases (P > 0.05). Moreover, all differences in laryngeal parameters between the end of the calm inspiratory phase and the breath-holding phase were statistically significant (P < 0.05), regardless of sex.

CONCLUSION

The relevant positional parameters of the vocal fold, arytenoid cartilage, and false vocal fold and their differences before and after vocal fold movement in healthy adult volunteers can be obtained objectively using TLUSG.