Impact of vocal cord ultrasonography on endocrine surgery practices

Vocal Cord Palsies Missed by Transcutaneous Laryngeal Ultrasound (TLUSG): Do They Experience Worse Outcomes?

“…Like this study, all reported TLUSG‐missed VCP (or false‐negative results) were found in patients with decreased VCs movement, i.e. VC paresis, on laryngoscopy [9, 10, 14, 18, 21]. By putting the USG probe transversely over thyroid cartilage, no VC complete paralysis was missed [15, 21].…”

“…These false-negative results (i.e. TLUSG showed normal VC movement but laryngoscopic examination reviewed VCP) were infrequently present [9,10,14,[17][18][19][20][21]. It is unclear whether the outcome of these patients with VCP missed by TLUSG [false negative (FN)] was different from those with VCP diagnosed by TLUSG [true positive (TP)].…”

Transcutaneous Laryngeal Ultrasonography for Laryngeal Immobility Diagnosis in Patients with Voice Disorders After Thyroid/Parathyroid Surgery

“…Indeed, the technique seems quite accessible for non‐radiologists, with a fast learning curve of 10–20 examinations [12]. However, the reliability of this technique in determining RNLs is still questioned, with teams recommending TLUS as a valuable alternative to flexible laryngoscopy [13, 14] and others advising against it in the pre‐ and postoperative period, even when performed by radiologists trained in the USA [15, 16].…”

“…In the present study, we focused on the capacity of TLUS to diagnose laryngeal motion impairment. Indeed, while TLUS seems easily accessible to non-specialists [12], there is still debate to determine whether it is an accurate and reliable tool in the detection of recurrent nerve palsy, in either the pre-or postoperative period of thyroid surgery [13][14][15][16]. For example, Wong and al [13] found that the postoperative sensitivity, specificity, positive predictive value, and negative predictive value of TLUS in detecting abnormal laryngeal motion were 93.3, 97.8, 77.8, and 99.4%, respectively, while Borel et al [16] described a sensitivity of 33%, a specificity of 95%, a positive predictive value of 42%, and a negative predictive value of 89% for the postoperative diagnosis of the same pathology.…”

Editorial: Laryngeal evaluation for thyroid surgery: Back to the basics

“…Woo et al 1 describe their experience with lateral approach for laryngeal evaluation and they have concluded 100% sensitivity and 99% specificity for evaluation of vocal cord paralysis. They have compared the anterior and lateral approach for laryngeal evaluation with ultrasound, and Carneiro-Pla et al 2 report the use of surgeon-performed vocal cord ultrasound and reduced the incidence of flexible laryngoscopy. They concluded that ultrasound is a noninvasive and highly sensitive method of demonstrating vocal cord mobility and precludes preoperative flexible laryngoscopy in most patients requiring vocal cord visualization.…”