- •Transcutaneous laryngeal ultrasonography showed good vocal cord visualization.
- •Ultrasonography can be considered when laryngoscopy is unavailable.
- •Ultrasonography is diagnostically accurate in a variety of situations.
Early diagnosis of vocal cord iatrogenic injury is crucial, as is perioperative vocal cord evaluation.
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.
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]).
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.
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- Initial experience of vocal cord evaluation using grey-scale, real-time, B-mode ultrasound.ANZ J Surg. 2001; 71: 737-739
- Transcutaneous ultrasonography in early postoperative diagnosis of vocal cord palsy after total thyroidectomy.World J Surg. 2016; 40: 665-671
- Using transcutaneous laryngeal ultrasonography (TLUSG) to assess post-thyroidectomy patients' vocal cords: which maneuver best optimizes visualization and assessment accuracy?.World J Surg. 2016; 40: 652-658
- American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer.Thyroid. 2015; 2016: 1-133
- Assessing the validity of transcutaneous laryngeal ultrasonography (TLUSG) after thyroidectomy: what factors matter?.Ann Surg Oncol. 2015; 22: 1774-1780
- A prospective, assessor-blind evaluation of surgeon-performed transcutaneous laryngeal ultrasonography in vocal cord examination before and after thyroidectomy.Surgery. 2013; 154 (discussion 1164-1155): 1158-1164
- Lessons learned after 1000 cases of transcutaneous laryngeal ultrasound (TLUSG) with laryngoscopic validation: is there a role of TLUSG in patients indicated for laryngoscopic examination before thyroidectomy?.Thyroid. 2017; 27: 88-94
- Assessment of vocal fold function using transcutaneous laryngeal ultrasonography and flexible laryngoscopy.JAMA Otolaryngol -- Head & Neck Surg. 2016; 142: 74-78
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.BMJ. 2009; 339: b2535
- Optimal literature search for systematic reviews in surgery.Langenbeck's Arch Surg. 2018; 403: 119-129
- The efficacy of hypotensive agents on intraoperative bleeding and recovery following general anesthesia for nasal surgery: a network meta-analysis.Clin Exp Otorhinolaryngol. 2021; 14: 200-209
- Real-time, high-resolution ultrasonography of the vocal folds--a prospective pilot study in patients before and after thyroidectomy.Langenbeck's Arch Surg. 2010; 395: 859-864
- Feasibility of surgeon-performed transcutaneous vocal cord ultrasonography in identifying vocal cord mobility: a multi-institutional experience.Surgery. 2014; 156 (discussion 1602-1594): 1597-1602
- Accuracy of transcutaneous laryngeal ultrasound for detecting vocal cord paralysis in the immediate postoperative period after total thyroidectomy.Minerva Anestesiol. 2017; 83: 1239-1247
- Comparison of ultrasound frequency in laryngeal ultrasound for vocal cord evaluation.Surgery. 2017; 161: 1108-1112
- Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery.Langenbeck's Arch Surg. 2018; 403: 1015-1020
- Transcutaneous laryngeal ultrasonography for laryngeal immobility diagnosis in patients with voice disorders after thyroid/parathyroid surgery.World J Surg. 2018; 42: 2102-2108
- The role of ultrasonography in the assessment of vocal cord functions after thyroidectomy.J Invest Surg : Off J Acad Surg Res. 2018; 31: 24-28
- The utility of surgeon performed transcutaneous laryngeal ultrasound for the assessment of vocal cords in post-thyroidectomy patients.. 2018; 5 (2018): 5
- (☆)Comparison of transcutaneous laryngeal ultrasound with video laryngoscope for assessing the vocal cord mobility in patients undergoing thyroid surgery.Auris Nasus Larynx. 2019; 46: 593-598
- Recurrent laryngeal nerve injury assessment by intraoperative laryngeal ultrasonography: a prospective diagnostic test accuracy study.Wideochirurgia i inne techniki maloinwazyjne = Videosurg Miniinvas Techniq. 2019; 14: 38-45
- A prospective study evaluating the feasibility and accuracy of very early postoperative translaryngeal ultrasonography in the assessment of vocal cord function after neck surgery.Surgery. 2021; 169: 191-196
- A novel lateral-approach laryngeal ultrasonography for vocal cord evaluation.Surgery. 2016; 159: 52-56
- Transcutaneous laryngeal ultrasonography: a reliable, non-invasive and inexpensive preoperative method in the evaluation of vocal cords motility-a prospective multicentric analysis on a large series and a literature review.Updates Surg. 2020; 72: 885-892
Mahalakshmi VD, Mayilvaganan S, Ravisankar M et al. Surgeon-performed ultrasound analysis of the status of the vocal cords of post-thyroidectomy patients with intraoperative neuromonitoring in a tertiary referral center. Int J Mol & Immuno Oncol; 5.
- Meta-analysis of diagnostic and screening test accuracy evaluations: methodologic primer.AJR Am J Roentgenol. 2006; 187: 271-281
- Grading quality of evidence and strength of recommendations for diagnostic tests and strategies.BMJ. 2008; 336: 1106-1110
- GRADE: assessing the quality of evidence for diagnostic recommendations.ACP J Club. 2008; 149: 2
- Clinical Application of a Digital Method to Improve the Accuracy of Color Perception in Toluidine Blue Stained Oral Mucosal Lesions. vol. 44. Quintessence international, Berlin, Germany2013: 619-627 (1985)
Published online: August 15, 2021
Accepted: August 13, 2021
Received in revised form: August 4, 2021
Received: May 2, 2021
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