Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery
Purpose Direct flexible laryngoscopy (DFL) is the golden standard to evaluate the vocal cord (VC) function in thyroid and parathyroid surgery pre- and postoperatively. Transcutaneous laryngeal ultrasonography (TLUS) could represent an alternative to the DFL and has been evaluated in the present stud...
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| Veröffentlicht in: | Langenbeck's archives of surgery 2018-12, Vol.403 (8), p.1015-1020 |
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| creator | Knyazeva, Polina Makarin, Viktor Seeliger, Barbara Chernikov, Roman Sleptsov, Ilya Semenov, Arseny Walz, Martin K. Alesina, Pier F. |
| description | Purpose
Direct flexible laryngoscopy (DFL) is the golden standard to evaluate the vocal cord (VC) function in thyroid and parathyroid surgery pre- and postoperatively. Transcutaneous laryngeal ultrasonography (TLUS) could represent an alternative to the DFL and has been evaluated in the present study comparing the results of both methods performed at two referral centers for endocrine pathologies.
Methods
In the setting of a retrospective study, 668 patients (560 female, 118 male; mean age 50.3 ± 14.2) were included from two tertiary referral centers of endocrine surgery. In all patients, TLUS was performed pre- and postoperatively prior to transnasal DFL, which served as a golden standard. TLUS was performed by B-scan (probe 5–13 MHz, aperture 40 mm).
Results
Preoperative visualization of the vocal cords by TLUS was possible in 526 patients (78.7%). Due to the frequent thyroid cartilage calcification (TCC) in male patients, a significant difference in the visualization rate was found between female and male (88.7% vs. 26.8%) [
p
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| doi_str_mv | 10.1007/s00423-018-1734-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_04059403v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2139567835</sourcerecordid><originalsourceid>FETCH-LOGICAL-c378t-29c576207883d9c469dd82c36c9f119792a0a8beabb65c0462e30564edc595713</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhSMEoqXwAGyQl51FwP-xl1WhFCkSC6Zry3GcGVeeONjOiDwY74eHDLNkY1_5nnOse7-qeo_gRwRh8ylBSDGpIRI1agit-YvqGlHCakwZenmpKbmq3qT0DCHkjaSvqysCqRBYwuvq9zbqMZk569GGOQGv4zLurPZg9jnqFMawi3raL-B22z792ACdgB6B9tnGUWd3tCAH0LtoTQaDt79c5-05JSQTpmL8_NBugBtB3lsw2ehCOVarPWo_lzKMIAx_-8dgyt8mxB4cQue8y8tqXWJwPUhz3Nm4vK1eDdon--5831RPD1-29491-_3rt_u7tjakEbnG0rCGY9gIQXppKJd9L7Ah3MgBIdlIrKEWndVdx5mBlGNLIOPU9oZJ1iByU23W3L32aoruUOZSQTv1eNeq0xukkEkKyfGkvV21Uww_Z5uyOrhkrPfrZhVGRDLeCMKKFK1SE0NK0Q6XbATViaxayapCVp3IKl48H87xc3ew_cXxD2UR4FWQSqsgjOo5zIWRT_9J_QMt_LDr</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2139567835</pqid></control><display><type>article</type><title>Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Knyazeva, Polina ; Makarin, Viktor ; Seeliger, Barbara ; Chernikov, Roman ; Sleptsov, Ilya ; Semenov, Arseny ; Walz, Martin K. ; Alesina, Pier F.</creator><creatorcontrib>Knyazeva, Polina ; Makarin, Viktor ; Seeliger, Barbara ; Chernikov, Roman ; Sleptsov, Ilya ; Semenov, Arseny ; Walz, Martin K. ; Alesina, Pier F.</creatorcontrib><description>Purpose
Direct flexible laryngoscopy (DFL) is the golden standard to evaluate the vocal cord (VC) function in thyroid and parathyroid surgery pre- and postoperatively. Transcutaneous laryngeal ultrasonography (TLUS) could represent an alternative to the DFL and has been evaluated in the present study comparing the results of both methods performed at two referral centers for endocrine pathologies.
Methods
In the setting of a retrospective study, 668 patients (560 female, 118 male; mean age 50.3 ± 14.2) were included from two tertiary referral centers of endocrine surgery. In all patients, TLUS was performed pre- and postoperatively prior to transnasal DFL, which served as a golden standard. TLUS was performed by B-scan (probe 5–13 MHz, aperture 40 mm).
Results
Preoperative visualization of the vocal cords by TLUS was possible in 526 patients (78.7%). Due to the frequent thyroid cartilage calcification (TCC) in male patients, a significant difference in the visualization rate was found between female and male (88.7% vs. 26.8%) [
p
< 0.0001]. Additionally, the visualization rate was inversely related to the patient’s age [
p
< 0.001]. The sensitivity of preoperative TLUS was found to be 66.7%, the specificity 100%. DFL confirmed a postoperative palsy in 34 out of 40 patients with supposed abnormal vocal cord mobility at TLUS and demonstrated a palsy in four more cases with supposed regular mobility at TLUS. Therefore, the sensitivity of postoperative TLUS was 86%, the specificity of 99.1%, positive predictive value 89.4%, negative predictive value 98.7%.
Conclusions
TLUS could represent an alternative for the evaluation of vocal cords mobility. This method has the potential to replace the DFL in the majority of cases, especially in female patients. Nevertheless, DFL is still necessary in about 20% of the patients with failed visualization at TLUS.</description><identifier>ISSN: 1435-2443</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-018-1734-6</identifier><identifier>PMID: 30488290</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Cardiac Surgery ; Computer Science ; Female ; General Surgery ; Human health and pathology ; Humans ; Laryngoscopy ; Life Sciences ; Male ; Medical Imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - etiology ; Retrospective Studies ; Sensitivity and Specificity ; Surgery ; Thoracic Surgery ; Thyroid Diseases - diagnostic imaging ; Thyroid Diseases - surgery ; Thyroidectomy - adverse effects ; Traumatic Surgery ; Ultrasonography ; Vascular Surgery ; Vocal Cord Paralysis - diagnostic imaging ; Vocal Cord Paralysis - etiology</subject><ispartof>Langenbeck's archives of surgery, 2018-12, Vol.403 (8), p.1015-1020</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-29c576207883d9c469dd82c36c9f119792a0a8beabb65c0462e30564edc595713</citedby><cites>FETCH-LOGICAL-c378t-29c576207883d9c469dd82c36c9f119792a0a8beabb65c0462e30564edc595713</cites><orcidid>0000-0001-7451-7545</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00423-018-1734-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00423-018-1734-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30488290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-04059403$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Knyazeva, Polina</creatorcontrib><creatorcontrib>Makarin, Viktor</creatorcontrib><creatorcontrib>Seeliger, Barbara</creatorcontrib><creatorcontrib>Chernikov, Roman</creatorcontrib><creatorcontrib>Sleptsov, Ilya</creatorcontrib><creatorcontrib>Semenov, Arseny</creatorcontrib><creatorcontrib>Walz, Martin K.</creatorcontrib><creatorcontrib>Alesina, Pier F.</creatorcontrib><title>Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery</title><title>Langenbeck's archives of surgery</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Purpose
Direct flexible laryngoscopy (DFL) is the golden standard to evaluate the vocal cord (VC) function in thyroid and parathyroid surgery pre- and postoperatively. Transcutaneous laryngeal ultrasonography (TLUS) could represent an alternative to the DFL and has been evaluated in the present study comparing the results of both methods performed at two referral centers for endocrine pathologies.
Methods
In the setting of a retrospective study, 668 patients (560 female, 118 male; mean age 50.3 ± 14.2) were included from two tertiary referral centers of endocrine surgery. In all patients, TLUS was performed pre- and postoperatively prior to transnasal DFL, which served as a golden standard. TLUS was performed by B-scan (probe 5–13 MHz, aperture 40 mm).
Results
Preoperative visualization of the vocal cords by TLUS was possible in 526 patients (78.7%). Due to the frequent thyroid cartilage calcification (TCC) in male patients, a significant difference in the visualization rate was found between female and male (88.7% vs. 26.8%) [
p
< 0.0001]. Additionally, the visualization rate was inversely related to the patient’s age [
p
< 0.001]. The sensitivity of preoperative TLUS was found to be 66.7%, the specificity 100%. DFL confirmed a postoperative palsy in 34 out of 40 patients with supposed abnormal vocal cord mobility at TLUS and demonstrated a palsy in four more cases with supposed regular mobility at TLUS. Therefore, the sensitivity of postoperative TLUS was 86%, the specificity of 99.1%, positive predictive value 89.4%, negative predictive value 98.7%.
Conclusions
TLUS could represent an alternative for the evaluation of vocal cords mobility. This method has the potential to replace the DFL in the majority of cases, especially in female patients. Nevertheless, DFL is still necessary in about 20% of the patients with failed visualization at TLUS.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiac Surgery</subject><subject>Computer Science</subject><subject>Female</subject><subject>General Surgery</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Laryngoscopy</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Thyroid Diseases - diagnostic imaging</subject><subject>Thyroid Diseases - surgery</subject><subject>Thyroidectomy - adverse effects</subject><subject>Traumatic Surgery</subject><subject>Ultrasonography</subject><subject>Vascular Surgery</subject><subject>Vocal Cord Paralysis - diagnostic imaging</subject><subject>Vocal Cord Paralysis - etiology</subject><issn>1435-2443</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhSMEoqXwAGyQl51FwP-xl1WhFCkSC6Zry3GcGVeeONjOiDwY74eHDLNkY1_5nnOse7-qeo_gRwRh8ylBSDGpIRI1agit-YvqGlHCakwZenmpKbmq3qT0DCHkjaSvqysCqRBYwuvq9zbqMZk569GGOQGv4zLurPZg9jnqFMawi3raL-B22z792ACdgB6B9tnGUWd3tCAH0LtoTQaDt79c5-05JSQTpmL8_NBugBtB3lsw2ehCOVarPWo_lzKMIAx_-8dgyt8mxB4cQue8y8tqXWJwPUhz3Nm4vK1eDdon--5831RPD1-29491-_3rt_u7tjakEbnG0rCGY9gIQXppKJd9L7Ah3MgBIdlIrKEWndVdx5mBlGNLIOPU9oZJ1iByU23W3L32aoruUOZSQTv1eNeq0xukkEkKyfGkvV21Uww_Z5uyOrhkrPfrZhVGRDLeCMKKFK1SE0NK0Q6XbATViaxayapCVp3IKl48H87xc3ew_cXxD2UR4FWQSqsgjOo5zIWRT_9J_QMt_LDr</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Knyazeva, Polina</creator><creator>Makarin, Viktor</creator><creator>Seeliger, Barbara</creator><creator>Chernikov, Roman</creator><creator>Sleptsov, Ilya</creator><creator>Semenov, Arseny</creator><creator>Walz, Martin K.</creator><creator>Alesina, Pier F.</creator><general>Springer Berlin Heidelberg</general><general>Springer Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-7451-7545</orcidid></search><sort><creationdate>20181201</creationdate><title>Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery</title><author>Knyazeva, Polina ; Makarin, Viktor ; Seeliger, Barbara ; Chernikov, Roman ; Sleptsov, Ilya ; Semenov, Arseny ; Walz, Martin K. ; Alesina, Pier F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-29c576207883d9c469dd82c36c9f119792a0a8beabb65c0462e30564edc595713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiac Surgery</topic><topic>Computer Science</topic><topic>Female</topic><topic>General Surgery</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Laryngoscopy</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Thyroid Diseases - diagnostic imaging</topic><topic>Thyroid Diseases - surgery</topic><topic>Thyroidectomy - adverse effects</topic><topic>Traumatic Surgery</topic><topic>Ultrasonography</topic><topic>Vascular Surgery</topic><topic>Vocal Cord Paralysis - diagnostic imaging</topic><topic>Vocal Cord Paralysis - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knyazeva, Polina</creatorcontrib><creatorcontrib>Makarin, Viktor</creatorcontrib><creatorcontrib>Seeliger, Barbara</creatorcontrib><creatorcontrib>Chernikov, Roman</creatorcontrib><creatorcontrib>Sleptsov, Ilya</creatorcontrib><creatorcontrib>Semenov, Arseny</creatorcontrib><creatorcontrib>Walz, Martin K.</creatorcontrib><creatorcontrib>Alesina, Pier F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Langenbeck's archives of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knyazeva, Polina</au><au>Makarin, Viktor</au><au>Seeliger, Barbara</au><au>Chernikov, Roman</au><au>Sleptsov, Ilya</au><au>Semenov, Arseny</au><au>Walz, Martin K.</au><au>Alesina, Pier F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery</atitle><jtitle>Langenbeck's archives of surgery</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>403</volume><issue>8</issue><spage>1015</spage><epage>1020</epage><pages>1015-1020</pages><issn>1435-2443</issn><eissn>1435-2451</eissn><abstract>Purpose
Direct flexible laryngoscopy (DFL) is the golden standard to evaluate the vocal cord (VC) function in thyroid and parathyroid surgery pre- and postoperatively. Transcutaneous laryngeal ultrasonography (TLUS) could represent an alternative to the DFL and has been evaluated in the present study comparing the results of both methods performed at two referral centers for endocrine pathologies.
Methods
In the setting of a retrospective study, 668 patients (560 female, 118 male; mean age 50.3 ± 14.2) were included from two tertiary referral centers of endocrine surgery. In all patients, TLUS was performed pre- and postoperatively prior to transnasal DFL, which served as a golden standard. TLUS was performed by B-scan (probe 5–13 MHz, aperture 40 mm).
Results
Preoperative visualization of the vocal cords by TLUS was possible in 526 patients (78.7%). Due to the frequent thyroid cartilage calcification (TCC) in male patients, a significant difference in the visualization rate was found between female and male (88.7% vs. 26.8%) [
p
< 0.0001]. Additionally, the visualization rate was inversely related to the patient’s age [
p
< 0.001]. The sensitivity of preoperative TLUS was found to be 66.7%, the specificity 100%. DFL confirmed a postoperative palsy in 34 out of 40 patients with supposed abnormal vocal cord mobility at TLUS and demonstrated a palsy in four more cases with supposed regular mobility at TLUS. Therefore, the sensitivity of postoperative TLUS was 86%, the specificity of 99.1%, positive predictive value 89.4%, negative predictive value 98.7%.
Conclusions
TLUS could represent an alternative for the evaluation of vocal cords mobility. This method has the potential to replace the DFL in the majority of cases, especially in female patients. Nevertheless, DFL is still necessary in about 20% of the patients with failed visualization at TLUS.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30488290</pmid><doi>10.1007/s00423-018-1734-6</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-7451-7545</orcidid></addata></record> |
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| ispartof | Langenbeck's archives of surgery, 2018-12, Vol.403 (8), p.1015-1020 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Adult Aged Cardiac Surgery Computer Science Female General Surgery Human health and pathology Humans Laryngoscopy Life Sciences Male Medical Imaging Medicine Medicine & Public Health Middle Aged Original Article Postoperative Complications - diagnostic imaging Postoperative Complications - etiology Retrospective Studies Sensitivity and Specificity Surgery Thoracic Surgery Thyroid Diseases - diagnostic imaging Thyroid Diseases - surgery Thyroidectomy - adverse effects Traumatic Surgery Ultrasonography Vascular Surgery Vocal Cord Paralysis - diagnostic imaging Vocal Cord Paralysis - etiology |
| title | Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery |
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