Laryngeal Ultrasound Detects Vocal Fold Immobility in Adults

Abstract

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.

Is trans-laryngeal ultrasound (TLUS) an accurate and acceptable tool in the assessment of inducible laryngeal obstruction? A protocol for the ILOTUS: A cross-sectional, two-stage feasibility study

“…Ultrasound assessment of laryngeal function via TLUS has been described extensively within the literature in post-thyroidectomy populations (Allen et al, 2021;Beale et al, 2020;Dedecjus et al, 2010;Fung & Lang, 2021;Gambardella et al, 2020;Knyazeva et al, 2018;Nasser et al, 2020;Noel et al, n.d.;A. Patel et al, 2021;Rybakovas et al, 2019;Su et al, 2022), and has been found to have high sensitivity as a screening tool for vocal fold palsy. It is also described as a valid and reliable real-time diagnostic tool (Allen et al, 2021;Nasser et al, 2020;A.…”

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

“…SWE has been used to evaluate normal mechanical properties (stiffness) of skeletal muscles, and the change in increased passive muscle stiffness with stretched muscles. 11 There are a few reports of using ultrasound elastography (SWE and strain imaging) to assess FVF. 12 We aimed to investigate the feasibility of SWE for evaluation of mechanical properties, function, and symmetry in adult FVF with age.…”

“…Ultrasound imaging is not only beneficial in the sense that it provides a real‐time image for motion, but it also reduces the need for more invasive modalities to assess tissue functionality such as invasive transesophageal imaging of the larynx or surgical biopsy for histological assessment of FVF tissue. SWE has been used to evaluate normal mechanical properties (stiffness) of skeletal muscles, and the change in increased passive muscle stiffness with stretched muscles 11 . There are a few reports of using ultrasound elastography (SWE and strain imaging) to assess FVF 12 .…”