A prospective study comparing the midline and lateral trans-laryngeal ultrasonography approaches in vocal cord assessment before and after thyroid and neck surgeries

Abstract

Introduction: It is unclear if placing an ultrasound probe along each thyroid cartilage lamina (i.e. the lateral approach) can improve vocal cord (VC) visualization over in the midline (i.e. the midline approach) in trans-larygeal ultrasonography (TLUSG). This study compared VC visualization rates and diagnostic accuracy between the two approaches. Methods: Consecutive patients undergoing surgery had their VCs assessed by the two TLUSG approaches and flexible laryngoscopy within the same session. VC visualization rates and diagnostic accuracy of each approach were calculated and compared. Results: Ninety patients (or 180 VCs) were analyzed. The lateral approach had significantly better overall VC visualization rate than the midline approach (93.3% vs. 82.2%, p=<0.001), especially for males (75.0% vs. 33.3%, p = 0.002). Both approaches had comparable accuracy (100% vs. 99.4%). Conclusions: The lateral approach should be preferred because of the significantly better VC visualization rate and comparable accuracy to the midline approach.