Evaluation of transcutaneous laryngeal ultrasonography for vocal cord examination in the immediate postoperative period following total thyroidectomy


Institute(s): Valld´HebronUniversity Hospital, Dept of Anaesthesiology, Barcelona, Spain

Background and Goal of Study: Transcutaneous laryngeal ultrasound (TLUSG) has emerged as a promising imaging tool for vocal cord examination in patients undergoing thyroid surgery. The focus of this prospective study was to assess the accuracy of TLUS compared with videostrobolaryngoscopy (VSL) in the diagnosis of vocal cord paralysis in the immediate postoperative period following total thyroidectomy.

Materials and methods:Ninety-three patients undergoing total thyroidectomy and assessed by the 2 techniques were studied. VSL was carried out the day before surgery and was repeated at 4 days postoperatively. TLUS was performed before surgery in the preanesthesia holding area and at completion of the procedure in the postanesthesia care unit. The preoperative and postoperative TLUS results were compared with those of VSL. The statistical analysis included the sensitivity, specificity, positive predictive value, and negative predictive value (with 95% CI) of TLUS for detecting vocal cord paralysis. 

Results and discussion:The visualization rate associated with TLUS was 93%. The total vocal cord paralysis rate was 16.1%. The performance of TLUS for diagnosing this condition was as follows: sensitivity, 93.3% (95% CI, 77.3%-100%); specificity 96.1% (95% CI, 91.2%-100%); positive predictive value, 82.3% (95% CI, 61.2%-100%); negative predictive value, 98.6% (95%CI, 95.4%-100%).
The present study demonstrates that laryngeal examination using TLUSG, a noninvasive technique, has a high sensitivity, specificity, and positive predictive value for detecting vocal cord paralysis shortly after thyroidectomy

Conclusions: TLUS may be a suitable technique for detecting vocal cord paralysis shortly after total thyroidectomy.