The importance of sonographic landmarks by transcutaneous laryngeal ultrasonography in post-thyroidectomy vocal cord assessment
| Autor: | Yeo Kyu Youn, K.-E. Lee, Felix Che-Lok Chow, Brian Hung-Hin Lang, Kai Pun Wong, Jung Woo Woo |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Cord medicine.medical_treatment Laryngoscopy Diagnostic accuracy Vocal Cords Sensitivity and Specificity Statistics Nonparametric Cohort Studies Young Adult medicine False positive paradox Humans Prospective Studies Aged Aged 80 and over Observer Variation Postoperative Care Palsy medicine.diagnostic_test business.industry Thyroidectomy Ultrasonography Doppler Middle Aged Surgery Female Radiology Anatomic Landmarks Ultrasonography business Vocal Cord Paralysis True positive rate |
| Zdroj: | Surgery. 156:1590-1596 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2014.08.061 |
| Popis: | Introduction During examination of the vocal cords (VC) using transcutaneous laryngeal ultrasonography (TLUSG), 3 sonographic landmarks (namely, false VC [FC], true VC [TC], and arytenoids [AR]) are often seen. However, it remains unclear which landmark provides a more reliable assessment and whether seeing more landmarks improves the diagnostic accuracy and reliability. Methods We evaluated prospectively 245 patients from 2 centers. One assessor from each center performed all TLUSG examinations and their findings were validated by direct laryngoscopy. All 3 sonographic landmarks were routinely visualized whenever possible. The rate of visualization and diagnostic accuracy between the 3 landmarks were compared. Results Eighteen patients suffered postoperative VC palsy (VCP). Both centers had comparable visualization or assessability rate of ≥1 sonographic landmark (94.9 and 95.3%; P = 1.000) and 100% sensitivity on postoperative TLUSG. The rates of FC, TC, and AR visualization were 92.7%, 36.7%, and 89.8%, respectively. The sensitivity, specificity, and diagnostic accuracy and the proportion of true positives, false positives, and true negatives between using 1, 2, landmarks and 3 landmarks were comparable (P > .05). Conclusion Each sonographic landmark had similar reliability and diagnostic accuracy. Identifying all 3 sonographic landmarks was not mandatory and visualizing normal movement in one of the sonographic landmarks would be sufficient to exclude VCP. |
| Databáze: | OpenAIRE |
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