Assessment of functionality of vocal cords using ultrasound before and after thyroid surgery: An observational study

Abstract

Background and Aims:The preservation of recurrent laryngeal nerve (RLN) is an essential part of thyroid surgery. The various methods to test the normal functionality of vocal cords (VCs) include direct visualisation under the fiber bronchoscope, indirect laryngoscopy, laryngeal muscles electromyography, computed tomography (CT), and magnetic resonance imaging (MRI). We aimed to assess the usefulness of ultrasound (USG) in the examination of VC morphology and movement.Methods:After Institutional Ethical Committee (IEC) clearance, 65 American Society of Anesthesiologists physical status I/II patients between the age group 18 and 60 years scheduled for thyroid surgery were enrolled in this observational study. All patients underwent USG examination before, immediately after and 2 days after thyroidectomy. The vocal fold (VF) displacement velocity (VFDV) was recorded and analysed. If any VF disorder was detected, the patients underwent two additional examinations: 2 and 3 months after thyroidectomy. All the findings were correlated with those of video rhinolaryngoscope (VRL).Results:The visualisation rate of the VCs with USG was 96.9% whereas with VRL was 100%. Two patients had preoperative VC palsy that was picked up by USG and confirmed by VRL. The sensitivity and specificity of USG as a tool to detect paralysis were 100% CI = (0.34, 1.00) and 93.44% CI = (0.84, 0.97), respectively.Conclusion:USG examination can prove to be a good, noninvasive, cheap alternative to VRL in examination for functionality of VCs perioperatively.

Ultrasound Elastography Detects Age‐Related Changes in Adult False Vocal Folds

“…5 These results may be helpful as an important reference when evaluating diminished function of vocal folds caused by thyroid and parathyroid surgery, as well as other neuromuscular disorders (eg, Parkinson disease). [17][18][19] Our ultrasound elastography age-dependent findings for SWV and SWV ratio are consistent with observations by others that age-related FVF local tissue degeneration may lead to an increase of stiffness and decrease of function of FVF. 2,3 Having symmetry of FVF mechanical properties is essential for maintaining normal function of voice production, breathing, and swallowing.…”

The Role of Ultrasonography in Evaluating the Function of the Vocal Cords, Post-Thyroidectomy

“…However, US is a cheaper and noninvasive diagnostic alternative to these methods. 20 There are studies in the literature showing the success of US in assessing VC function after thyroidectomy, with a varied diagnostic range (33%-100%). 9,11,14,21 One of the first studies was reported by Sidhu et al, 21 and although VCs from all the study patients were evaluated, the sensitivity was only 62%.…”

Application of Translaryngeal Ultrasound (TLUS) in Patients with Neck Surgery—A Single-Centre, Prospective Cohort Study on Technique Evaluation

“…The VFDV was extensively investigated in many studies and the results were very promising regarding the practical implementation of this objective parameter. Dedecjus, Dubey and Kumar showed that the VFDV was significantly lower (<50% or <40 cm/s or 60 cm/s) after surgery resulting in VF injury [ 11 , 22 , 23 ]. In the literature, normal values ranged from 60–300 cm/s [ 12 ].…”