Department of Small Animal Diagnostic Imaging, CHV Frégis - IVC Evidensia, Arcueil, France.
Department of Small Animal Surgery, CHV Frégis - IVC Evidensia, Arcueil, France.
Vet Radiol Ultrasound. 2023 Mar;64(2):183-193. doi: 10.1111/vru.13192. Epub 2022 Dec 2.
The gold standard for diagnosis of laryngeal paralysis is laryngoscopy under light anesthesia. This prospective analytical cross-sectional study aimed to determine whether a radiographic assessment of the larynx could be used as a non-invasive screening tool for diagnosing laryngeal paralysis in non-sedated animals, as the laryngeal ventricles may appear wider in affected animals. The laryngeal ventricles of 18 dogs with bilateral laryngeal paralysis composing the affected group and 25 non-sedated dogs presenting no respiratory abnormality composing the control group were evaluated using right lateral radiography of the larynx. Three observers measured the ratios of the maximal ventricular length and surface to the body length of the third cervical vertebra (MVL/LC3 and VS/LC3, respectively). They also subjectively assessed the ventricular shape as either normal or rounded. The most accurate criterion was found to be MVL/LC3, as the respective areas under the ROC curves were 0.96 (95% confidence interval [CI]: 0.95-0.97), 0.89 (95% CI: 0.87-0.91), 0.80 (95% CI: 0.65-0.95) for MVL/LC3, VS/LC3, and ventricular shape evaluation, respectively. Based on ROC curve analysis, two thresholds of clinical interest were set for the MVL/LC3; bilateral laryngeal paralysis was very unlikely for values < 0.3 and very likely for values > 0.5. The findings of this study support the use of lateral laryngeal radiography as a screening tool for diagnosing bilateral laryngeal paralysis. However, further diagnostic tests remain required if MVL/LC3 lies between these threshold values or if clinically indicated. Further studies are warranted to explore the use of laryngeal radiography in unilateral paralysis and other laryngeal or oropharyngeal diseases.
诊断喉麻痹的金标准是在轻度麻醉下进行喉镜检查。本前瞻性分析性横断面研究旨在确定是否可以使用喉部的放射评估作为非侵入性筛查工具，用于诊断非镇静动物中的喉麻痹，因为受影响的动物的喉室可能看起来更宽。使用喉的右侧侧位片评估了 18 只双侧喉麻痹犬组成的患病组和 25 只无呼吸异常的非镇静犬组成的对照组的喉室。三名观察者测量了最大喉室长度与第三颈椎体长（MVL/LC3 和 VS/LC3）的比值。他们还主观评估了喉室的形状是正常还是圆形。发现最准确的标准是 MVL/LC3，因为各自的 ROC 曲线下面积分别为 0.96（95%置信区间 [CI]：0.95-0.97）、0.89（95% CI：0.87-0.91）、0.80（95% CI：0.65-0.95）用于 MVL/LC3、VS/LC3 和心室形状评估。基于 ROC 曲线分析，为 MVL/LC3 设置了两个有临床意义的阈值；如果值 <0.3，则双侧喉麻痹极不可能，如果值 >0.5，则极有可能。这项研究的结果支持使用侧位喉 X 线摄影作为诊断双侧喉麻痹的筛查工具。然而，如果 MVL/LC3 介于这些阈值之间或临床需要，仍需要进一步的诊断测试。需要进一步的研究来探讨在单侧麻痹和其他喉或口咽疾病中使用喉 X 射线摄影的情况。
