Ultrasonography assessment of vocal cords mobility in children after cardiac surgery

Shaath, Ghassan; Jijeh, Abdulraouf; Alkurdi, Ahmad; Ismail, Sameh R.; Elbarbary, Mahmoud; Kabbani, Mohamed S.

doi:10.1016/j.jsha.2012.02.009

Cited by 30 publications

(44 citation statements)

References 16 publications

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“…This explains why the value of specificity is lower than that of sensitivity. 9 Thus, our study highlights the feasibility and reliability of the US for the assessment of vocal cords paralysis after extubation.…”

Section: Ultrasound Enhanced Management Of Hypoxia/mechanical Ventilamentioning

confidence: 59%

“…Ultrasound not only allows a good tissue differentiation, but also has the advantage of dynamic vocal cord evaluation. 9 Our results show that US is a good sensitive test for ruling out vocal cord paralysis. When the test is positive, there is a possibility that the cord just has slight movements and is not totally paralysed.…”

Section: Ultrasound Enhanced Management Of Hypoxia/mechanical Ventilamentioning

confidence: 65%

See 1 more Smart Citation

'Critical' ultrasound: the new essential skill in Pediatric Cardiac Intensive Care Unit (PCICU)

Elbarbary

Ismail

Shaath

et al. 2014

European Heart Journal Supplements

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With the recent introduction of a high-quality, reasonably priced, and completely portable pediatric/neonatal ultrasound (US) machines, a new philosophy of US imaging emerged which is the 'critical ultrasound'. This is a paradigm shift from being organbased, systematic, comprehensive diagnostic exam done by radiologists to a new concept of problem-based, goal-directed, focused multi-organ, time-dependent, exam done by the treating intensivist. Based on this concept, the US exam is not done for an organ (e.g. US for abdomen or chest) but rather done to enhance the management of a problem (US for hypotension, US for hypoxia, US for sepsis, etc.). Certain problem-based US exams can involve scanning of multiple organs to enhance the management of certain patient's problem. The US within this concept is not considered just as diagnostic tool but rather as an integral part of pediatric cardiac intensive care (PCICU) management that involves diagnosis, tailored treatment, monitoring effects, goal-directed therapy, ruling out possible complications, and to guide most of PCICU procedures. This article describes some of the applications of this innovative program over a 6-year period in a PCICU and its impact on patient care.

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Section: Ultrasound Enhanced Management Of Hypoxia/mechanical Ventilamentioning

confidence: 59%

Section: Ultrasound Enhanced Management Of Hypoxia/mechanical Ventilamentioning

confidence: 65%

'Critical' ultrasound: the new essential skill in Pediatric Cardiac Intensive Care Unit (PCICU)

Elbarbary

Ismail

Shaath

et al. 2014

European Heart Journal Supplements

View full text Add to dashboard Cite

show abstract

“…In our study, we placed the transducer directly on the VFs, the so-called direct approach. However, other researchers placed the transducer on the skin of the patient, which is called the transcutaneous approach [10,11,[13][14][15]54,[68][69][70]. In the direct approach, it was easy to identify the VFs, whereas in transcutaneous approaches, the visualization rate was only 36.7% for the true VFs [71].…”

Section: Measurements On the Vfsmentioning

confidence: 99%

Imaging the Vocal Folds: A Feasibility Study on Strain Imaging and Elastography of Porcine Vocal Folds

et al. 2019

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Vocal folds are an essential part of human voice production. The biomechanical properties are a good indicator for pathological changes. In particular, as an oscillation system, changes in the biomechanical properties have an impact on the vibration behavior. Subsequently, those changes could lead to voice-related disturbances. However, no existing examination combines biomechanical properties and spatial imaging. Therefore, we propose an image registration-based approach, using ultrasound in order to gain this information synchronously. We used a quasi-static load to compress the tissue and measured the displacement by image registration. The strain distribution was directly calculated from the displacement field, whereas the elastic properties were estimated by a finite element model. In order to show the feasibility and reliability of the algorithm, we tested it on gelatin phantoms. Further, by examining ex vivo porcine vocal folds, we were able to show the practicability of the approach. We displayed the strain distribution in the tissue and the elastic properties of the vocal folds. The results were superimposed on the corresponding ultrasound images. The findings are promising and show the feasibility of the suggested approach. Possible applications are in improved diagnosis of voice disorders, by measuring the biomechanical properties of the vocal folds with ultrasound. The transducer will be placed on the vocal folds of the anesthetized patient, and the elastic properties will be measured. Further, the understanding of the vocal folds’ biomechanics and the voice forming process could benefit from it.

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“…Shaath et al [56] assessed the accuracy of US in detection the vocal cord mobility in children after cardiac surgery in comparison with standard fiber-optic laryngoscopy and reported a sensitivity of 100% and specificity of 80% in 10 patients with persistent significant upper airway obstruction. A recent case report [57] shows a successful detection of recurrent laryngeal nerve palsy in the immediate postoperative period after thyroid surgery.…”

Section: Airway Assessmentmentioning

confidence: 99%

Lung Ultrasound in the Critically Ill

Cho

2017

Korean J Crit Care Med

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Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum.

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Ultrasonography assessment of vocal cords mobility in children after cardiac surgery

Abstract: US assessment of vocal cord is simple, non-invasive and reliable tool to assess vocal cords mobility in the critical care settings. This screening tool requires skills that can be easily obtained.

Cited by 30 publications

References 16 publications

'Critical' ultrasound: the new essential skill in Pediatric Cardiac Intensive Care Unit (PCICU)

'Critical' ultrasound: the new essential skill in Pediatric Cardiac Intensive Care Unit (PCICU)

Imaging the Vocal Folds: A Feasibility Study on Strain Imaging and Elastography of Porcine Vocal Folds

Lung Ultrasound in the Critically Ill

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