The Role of Ultrasonography in Evaluating the Function of the Vocal Cords, Post-Thyroidectomy

Abstract

Objective: Although there are several methods to assess vocal cord (VC) paralysis, direct flexible laryngoscopy (DFL) is used as a main diagnostic modality. In recent years, transcutaneous laryngeal ultrasonography (TLUS) has emerged as an alternative method to evaluate VCs. The objective of this study was to investigate the efficiency of TLUS in the evaluation of VCs, post-thyroidectomy. Materials and Methods: The study included 93 patients who had undergone thyroid surgery. All patients were examined using DFL, 1 to 3 days before surgery, to evaluate their VC functions. Patients were examined using DFL and TLUS on postoperative day 7. Patients’ age, sex, diagnosis, type of surgery, preoperative DFL findings, postoperative DFL, and TLUS findings were recorded. Results: Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) were 75% (6/8), 98.66% (74/75), 85.71% (6/7), and 97.36% (74/76), respectively. The diagnostic accuracy of TLUS was 97.96%. The area under the receiver operator characteristic (ROC) curve was 0.869, P value <.0001 (95% confidence inteval, 0.75–1.00), which indicated that TLUS was a good tool for identification of VC palsy in this cohort of post-thyroidectomy patients. Conclusion: This cohort study demonstrated that TLUS was a reliable diagnostic tool to evaluate VC functions in patients after thyroidectomy. It may be used as a safer alternative during the ongoing COVID-19 pandemic due to the lack of human-originated aerosols.