Shetmahajan Madhavi, Vignesh M, Patil Vijaya, Parab Swapnil Yeshwant, Ranganathan Priya
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Department of Critical Care, Yashoda Hospital, Secunderabad, Telangana, India.
Indian J Anaesth. 2023 Sep;67(9):791-795. doi: 10.4103/ija.ija_316_23. Epub 2023 Sep 6.
Translaryngeal ultrasonography (TLUSG) for diagnosis of vocal cord palsy, a relatively new, safe and noninvasive bedside technique with minimal risk of respiratory infection transmission, has been effective in patients with thyroid disease. We studied its use as an alternative method to visual inspection by flexible laryngoscopy (FL) for vocal cord assessment in patients undergoing thoracic surgeries.
After Institutional Ethics Committee approval and trial registration, in this single-arm, prospective study, the vocal cord function of 110 patients who underwent either total oesophagectomy or mediastinoscopy was assessed immediately after extubation by both FL and TLUSG. A follow-up assessment was done by laryngoscopy using Hopkin's endoscope (HL) and a repeat TLUSG. The primary outcome was the concordance between direct visualisation (FL or HL) and TLUSG.
Vocal cords were successfully visualised by TLUSG in 90% of male and all female patients. Findings of FL and TLUSG done at the first assessment matched in 89 (86.4%) out of 103 patients, and the degree of concordance was 0.69 (95% confidence interval [CI] =0.52-0.83). At the second assessment, HL and TLUSG findings matched in 83 (94.3%) out of 88 patients, and the degree of concordance was 0.89 (95% CI = 0.77-0.98).
TLUSG is an effective noninvasive alternative to direct visualisation for vocal cord assessment in both male and female patients undergoing thoracic surgery.
经喉超声检查（TLUSG）用于诊断声带麻痹，这是一种相对新颖、安全且无创的床旁技术，呼吸道感染传播风险极小，已被证明对甲状腺疾病患者有效。我们研究了在接受胸外科手术的患者中，将其作为一种替代方法用于经纤维喉镜（FL）直视检查来评估声带功能。
经机构伦理委员会批准并进行试验注册后，在这项单臂前瞻性研究中，对110例行全食管切除术或纵隔镜检查的患者，在拔管后立即采用FL和TLUSG评估声带功能。使用Hopkins内镜（HL）进行喉镜检查及重复TLUSG进行随访评估。主要结局是直接可视化检查（FL或HL）与TLUSG之间的一致性。
在90%的男性患者和所有女性患者中，TLUSG成功可视化声带。在103例患者中，首次评估时FL和TLUSG的结果在89例（86.4%）中匹配，一致性程度为0.69（95%置信区间[CI]=0.52 - 0.83）。在第二次评估时，88例患者中有83例（94.3%）HL和TLUSG结果匹配，一致性程度为0.89（95% CI = 0.77 - 0.98）。
对于接受胸外科手术的男性和女性患者，TLUSG是一种有效的无创替代直接可视化检查来评估声带功能的方法。
