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Article: The importance of sonographic landmarks by transcutaneous laryngeal ultrasonography in post-thyroidectomy vocal cord assessment

TitleThe importance of sonographic landmarks by transcutaneous laryngeal ultrasonography in post-thyroidectomy vocal cord assessment
Authors
Issue Date2014
PublisherMosby, Inc. The Journal's web site is located at http://www.medicinepublishing.co.uk/index.php/surgery/
Citation
Surgery, 2014, v. 156 n. 6, p. 1590-1596 How to Cite?
AbstractDuring examination of the vocal cords (VC) using transcutaneous laryngeal ultrasonography (TLUSG), 3 sonographic landmarks (namely, false VC [FC], true VC [TC], and arytenoids [AR]) are often seen. However, it remains unclear which landmark provides a more reliable assessment and whether seeing more landmarks improves the diagnostic accuracy and reliability. METHODS: We evaluated prospectively 245 patients from 2 centers. One assessor from each center performed all TLUSG examinations and their findings were validated by direct laryngoscopy. All 3 sonographic landmarks were routinely visualized whenever possible. The rate of visualization and diagnostic accuracy between the 3 landmarks were compared. RESULTS: Eighteen patients suffered postoperative VC palsy (VCP). Both centers had comparable visualization or assessability rate of ≥ 1 sonographic landmark (94.9 and 95.3%; P = 1.000) and 100% sensitivity on postoperative TLUSG. The rates of FC, TC, and AR visualization were 92.7%, 36.7%, and 89.8%, respectively. The sensitivity, specificity, and diagnostic accuracy and the proportion of true positives, false positives, and true negatives between using 1, 2, landmarks and 3 landmarks were comparable (P > .05). CONCLUSION: Each sonographic landmark had similar reliability and diagnostic accuracy. Identifying all 3 sonographic landmarks was not mandatory and visualizing normal movement in one of the sonographic landmarks would be sufficient to exclude VCP. Copyright © 2014 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/207757
ISSN
2015 Impact Factor: 3.309
2015 SCImago Journal Rankings: 1.620

 

DC FieldValueLanguage
dc.contributor.authorWong, KPen_US
dc.contributor.authorWoo, JWen_US
dc.contributor.authorYoun, YKen_US
dc.contributor.authorChow, FCen_US
dc.contributor.authorLee, KEen_US
dc.contributor.authorLang, BHHen_US
dc.date.accessioned2015-01-19T10:16:30Z-
dc.date.available2015-01-19T10:16:30Z-
dc.date.issued2014en_US
dc.identifier.citationSurgery, 2014, v. 156 n. 6, p. 1590-1596en_US
dc.identifier.issn0039-6060-
dc.identifier.urihttp://hdl.handle.net/10722/207757-
dc.description.abstractDuring examination of the vocal cords (VC) using transcutaneous laryngeal ultrasonography (TLUSG), 3 sonographic landmarks (namely, false VC [FC], true VC [TC], and arytenoids [AR]) are often seen. However, it remains unclear which landmark provides a more reliable assessment and whether seeing more landmarks improves the diagnostic accuracy and reliability. METHODS: We evaluated prospectively 245 patients from 2 centers. One assessor from each center performed all TLUSG examinations and their findings were validated by direct laryngoscopy. All 3 sonographic landmarks were routinely visualized whenever possible. The rate of visualization and diagnostic accuracy between the 3 landmarks were compared. RESULTS: Eighteen patients suffered postoperative VC palsy (VCP). Both centers had comparable visualization or assessability rate of ≥ 1 sonographic landmark (94.9 and 95.3%; P = 1.000) and 100% sensitivity on postoperative TLUSG. The rates of FC, TC, and AR visualization were 92.7%, 36.7%, and 89.8%, respectively. The sensitivity, specificity, and diagnostic accuracy and the proportion of true positives, false positives, and true negatives between using 1, 2, landmarks and 3 landmarks were comparable (P > .05). CONCLUSION: Each sonographic landmark had similar reliability and diagnostic accuracy. Identifying all 3 sonographic landmarks was not mandatory and visualizing normal movement in one of the sonographic landmarks would be sufficient to exclude VCP. Copyright © 2014 Elsevier Inc. All rights reserved.-
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.medicinepublishing.co.uk/index.php/surgery/-
dc.relation.ispartofSurgeryen_US
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Surgery, 2014, v. 156 n. 6, p. 1590-1596. DOI: 10.1016/j.surg.2014.08.061-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleThe importance of sonographic landmarks by transcutaneous laryngeal ultrasonography in post-thyroidectomy vocal cord assessmenten_US
dc.typeArticleen_US
dc.identifier.emailWong, KP: kpwongb@hku.hken_US
dc.identifier.emailLang, HHB: Blang@hku.hken_US
dc.identifier.authorityWong, KP=rp02007en_US
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.surg.2014.08.061-
dc.identifier.pmid25456958-
dc.identifier.hkuros242062en_US
dc.identifier.volume156en_US
dc.identifier.issue6en_US
dc.identifier.spage1590en_US
dc.identifier.epage1596en_US
dc.publisher.placeUnited States-

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