Woo Jung-Woo, Suh Hyunsuk, Song Ra-Yeong, Lee Joon-Hyop, Yu Hyeong Won, Kim Su-jin, Chai Young Jun, Choi June Young, Lee Kyu Eun
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.
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.
Surgery. 2016 Jan;159(1):52-6. doi: 10.1016/j.surg.2015.07.043. Epub 2015 Sep 28.
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.
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.
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.
The new LUS approach significantly enhances the visualization of vocal cords and, therefore, overall diagnostic efficacy of LUS in male patients.
喉超声检查（LUS）是评估声带麻痹（VCP）风险患者声带（VC）的一种新方法。然而，据报道，先前描述的前入路LUS在男性患者中声带可视化失败率较高。我们设计了一种新型侧入路LUS以克服这一局限性。
对接受甲状腺切除术和甲状旁腺切除术的围手术期患者连续进行了382次（82例男性，300例女性）LUS和直接喉镜检查（DL）。女性患者采用前入路LUS，而男性患者采用侧入路LUS。检查结果与DL检查进行独立交叉验证。
前入路和侧入路LUS方法的可视化率均为100%（无可视化失败），对VCP的总体敏感性为100%（23/23），特异性为99.2%（356/359）。在300例女性患者中，18例患有VCP。前入路LUS的敏感性和特异性分别为100%（18/18）和99.3%（280/282）。在80例男性患者中，5例患有VCP。侧入路LUS的敏感性和特异性分别为100%（5/5）和98.7%（76/77）。
新的LUS方法显著提高了声带的可视化程度，从而提高了LUS在男性患者中的总体诊断效能。
