Jung-Woo Woo1, Hyunsuk Suh2, Ra-Yeong Song3, Joon-Hyop Lee4, Hyeong Won Yu3, Su-jin Kim3, Young Jun Chai5, June Young Choi4, Kyu Eun Lee6. 1. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Mount Sinai Beth Israel Hospital, Icahn School of Medicine at Mount Sinai, New York, NY. 3. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. 4. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. 5. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Boramae Medical Center, Seoul, Korea. 6. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. Electronic address: kyueunlee@snu.ac.kr.
Abstract
BACKGROUND: Laryngeal ultrasonography (LUS) is a new method of vocal cord (VC) evaluation in patients with risk of vocal cord palsy (VCP). The previously described anterior-approach LUS reportedly, however, has high failure rate of VC visualization in male patients. We devised a novel lateral-approach LUS to overcome this limitation. METHODS: A total of 382 (82 male, 300 female) consecutive LUS and direct laryngoscopy (DL) examinations were performed on perioperative thyroidectomy and parathyroidectomy patients. The anterior-approach LUS was used for female patients whereas the lateral-approach LUS was used for male patients. Findings were cross-validated independently with DL examinations. RESULTS: Both anterior and lateral LUS methods had 100% visualization rate (no failed visualization) with an overall sensitivity of 100% (23/23) and specificity of 99.2% (356/359) for VCP. Among the 300 female patients, 18 patients had VCP. Sensitivity and specificity of anterior-approach LUS were 100% (18/18) and 99.3% (280/282), respectively. Among the 80 male patients, 5 patients had VCP. Sensitivity and specificity of lateral-approach LU were 100% (5/5) and 98.7% (76/77), respectively. CONCLUSION: The new LUS approach significantly enhances the visualization of vocal cords and, therefore, overall diagnostic efficacy of LUS in male patients.
BACKGROUND: Laryngeal ultrasonography (LUS) is a new method of vocal cord (VC) evaluation in patients with risk of vocal cord palsy (VCP). The previously described anterior-approach LUS reportedly, however, has high failure rate of VC visualization in male patients. We devised a novel lateral-approach LUS to overcome this limitation. METHODS: A total of 382 (82 male, 300 female) consecutive LUS and direct laryngoscopy (DL) examinations were performed on perioperative thyroidectomy and parathyroidectomy patients. The anterior-approach LUS was used for female patients whereas the lateral-approach LUS was used for male patients. Findings were cross-validated independently with DL examinations. RESULTS: Both anterior and lateral LUS methods had 100% visualization rate (no failed visualization) with an overall sensitivity of 100% (23/23) and specificity of 99.2% (356/359) for VCP. Among the 300 female patients, 18 patients had VCP. Sensitivity and specificity of anterior-approach LUS were 100% (18/18) and 99.3% (280/282), respectively. Among the 80 male patients, 5 patients had VCP. Sensitivity and specificity of lateral-approach LU were 100% (5/5) and 98.7% (76/77), respectively. CONCLUSION: The new LUS approach significantly enhances the visualization of vocal cords and, therefore, overall diagnostic efficacy of LUS in male patients.
Authors: Jin Wook Yi; Sang Gab Yoon; Hyun Soo Kim; Hyeong Won Yu; Su-Jin Kim; Young Jun Chai; June Young Choi; Kyu Eun Lee Journal: Ann Surg Treat Res Date: 2017-07-30 Impact factor: 1.859