Surgeon-Performed Transcutaneous Laryngeal Ultrasound for Vocal Cord Assessment After Thyroid Surgery: a Prospective Study

Background Transcutaneous laryngeal ultrasound (TLUS) has recently been proposed as a promising and non-invasive alternative to flexible nasolaryngoscopy (FNL) for vocal cord (VC) mobility evaluation. Materials and Methods We conducted a prospective study on patients underwent thyroidectomy. All patients underwent TLUS and thereafter were evaluated by means of FNL by a blinded otolaryngologist. The findings were classified as normal or vocal fold movement impairment and were compared. Patients who were evaluable at TLUS were included in Group A, whereas those not evaluable were included in Group B: the features of the two groups were compared. The primary objective of the study was to assess the efficacy of surgeon-performed TLUS for the evaluation of VCs mobility in comparison to FNL. Secondary objective of the study was to identify factors which influence the assessability of VCs during TLUS. Results 180 patients were included in Group A, whereas 21 were include in Group B. Male sex (p<0.001), presence of thyroid cartilage calcification (p<0.001), older age (p=0.034), elevated BMI (p<0.001), thyroid volume (p=0.038) and neck circumference (p<0.001) resulted associated to Group B. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TLUS were 100%, 99.4%, 94.4%, 100% and 99.4%, respectively. Conclusion TLUS is a valid, easy-to-perform, non-invasive and painless alternative method for evaluating the vocal cords in selected patients.