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Perioperative transcutaneous laryngeal ultrasonography to assess vocal cord function in thyroid surgery

Journal

AMERICAN JOURNAL OF SURGERY
Volume 223, Issue 5, Pages 893-899

Publisher

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2021.08.019

Keywords

Thyroidectomy; Laryngoscopy; Larynx; Ultrasonography; Vocal cord paralysis; Thyroidectomy; Laryngoscopy; Larynx; Ultrasonography; Vocal cord paralysis

Categories

Funding

  1. Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education [2020R1I1A1A01051844]
  2. Bio & Medical Technology Development Program of the National Research Foundation (NRF) - Ministry of Science ICT [2019M3A9H2032424, 2019M3E5D5064110]

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This study compares the results of transcutaneous laryngeal ultrasonography with laryngoscopy and finds that transcutaneous laryngeal ultrasonography can be used for evaluating vocal cord mobility with high diagnostic accuracy. It can be considered as an alternative method when laryngoscopy is not available or refused by patients.
Background: Early diagnosis of vocal cord iatrogenic injury is crucial, as is perioperative vocal cord evaluation. Methods: Vocal cord mobility detected via transcutaneous laryngeal ultrasonography was compared with that detected via laryngoscopy (the reference). The vocal cord visualization rate of ultrasonography for evaluation of mobility was explored. Results: The diagnostic odds ratio of transcutaneous laryngeal ultrasonography was 303.2212 (95% CI, [86.7944; 1059.3198]). The area under the summary receiver operating characteristic curve was 0.944. The sensitivity, specificity, and negative predictive value were 0.9154 [0.8471; 0.9548], 0.9771 [0.9541; 0.9887], and 0.9915 [0.9868; 0.9946], respectively. The vocal cord visualization of ultrasonography used to evaluate vocal cord mobility was high (0.9572 [0.9091; 0.9804]). Conclusions: Since transcutaneous laryngeal ultrasonography has the advantage in vocal cord visualization, it can be considered when laryngoscopy is unavailable or patients refuse laryngoscopy. Also, it is diagnostically accurate regardless of the used landmarks, VCP definition, and timing for application. (c) 2021 Elsevier Inc. All rights reserved.

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