Anästhesie und klinische Forschung
Offener Zugang

Abstrakt

Comparing the Efficacy of Transcutaneous Laryngeal Ultrasonography and Direct Laryngoscopy in Assessing the Function of Vocal Cords in Postoperatively in Thyroidectomy Patients

Sreya Sri, Harish Singh, Parul Jindal*, Sampan Singh

Introduction: Transcutaneous Laryngeal Ultrasonography (TLUSG) can be used as an alternative to direct laryngoscopy.

Objective: To compare TLUSG and direct laryngoscopy in accessing the vocal cord mobility of elective thyroidectomy patients in the immediate postoperative period.

Methods: A total of 40 patients were enrolled in the study. All of them underwent indirect laryngoscopy and TLUSG pre-operatively. Patients with known vocal cord pathologies were excluded. All Patients underwent both TLUSG and Direct Laryngoscopy (DL) at extubation and indirect and TLUSG at discharge. During the examinations the movement of vocal cords was graded. Grade I: both vocal cords had normal movement; grade II: greater than or equal to one vocal cord had decreased movement; and grade III ≥ one vocal cord had no movement. To assess accuracy, TLUSG findings were correlated with direct laryngoscopy findings. Hemodynamic parameters and patients’ comfort were assessed during both the procedures. Paired t test, and Chi-square test were used as applicable to analyse data.

Results: No patient had preoperative Vocal Cord Palsy (VCP), and 3(7.5%) had unilateral postoperative VCP of which only 2(5%) were detected by direct laryngoscopy. The overall postoperative VCP rate in the immediate postoperative period was 7.5%. TLUSG failed to assess VCs in 3 (7.5%) postoperatively at extubation. But, could assess all the patients 100% when it was done at discharge. Out of the three vocal cord palsy as diagnosed at extubation one (2.5%) was resolved, 2(5%) were picked up by TLUSG of which only one (5%) was detected by indirect laryngoscopy. Sensitivity and specificity of TLUSG at extubation was 97.42%, 66%, respectively and at discharge was 97.2%, 100% respectively. Hemodynamic parameters and patients reactivity score was better while performing TLUSG .

Conclusion: TLUSG is an upcoming diagnostic modality which is cheap, non-invasive and comfortable to the patient and can assess the vocal cord function in the post thyroidectomy patients accurately.