Real-time, high-resolution ultrasonography of the vocal folds--a prospective pilot study in patients before and after thyroidectomy.
OBJECTIVE
The aim of the study was to evaluate the functionality of vocal folds (VF) by real-time, high-resolution ultrasonography (US) and to correlate the imaged features to results of laryngological examination (LE).


METHODS
The study group comprised 50 patients (41 females and nine males), qualified to thyroidectomy. All the patients had LE and US examination before and 2 days, 2 months, and 3 months after the surgery. We used high-resolution US imaging to identify VFs and, subsequently, a pulsed Doppler and Doppler gate to quantify the tissue displacement velocity in the vibrating VF section.


RESULTS
LE revealed unilateral VF paralysis in two patients. VF dysfunction was diagnosed in other four subjects. In simultaneously performed US examination, changes in VF displacement velocity (VFDV) were observed in ten patients. In two subjects, VFDV was below 30 cm/s- patients with VF paralysis, diagnosed in LE. In a further eight cases, we observed VFDV decrease by 50%, comparing to preoperative values. Both US-imaging and LE, performed after the 3-month follow-up, confirmed the transitional character of the above-mentioned pathologies.


CONCLUSIONS
US imaging of the VFs correlated with LE results, while being a minimally invasive, easily reproducible, and inexpensive method of examining VF functionality. Thanks to many recording options, it may soon become a perfect tool for an early identification of postoperative VF dysfunction with its later monitoring. To our knowledge, it is the first application of US and Doppler gate modes for VFDF quantification; however, an analysis on a larger group of patients is necessary to standardize the technique.
Dedecjus
Marek
M
Department of General, Oncological and Endocrine Surgery, Medical University of Lodz, Polish Mother's Memorial Hospital-Research Institute, No 281/289, The Rzgowska St, 93-338 Lodz, Poland. mdedecjus@wp.pl
Adamczewski
Zbigniew
Z
Brzeziński
Jan
J
Lewiński
Andrzej
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002648:Child; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014826:Vocal Cord Paralysis / Q000517:prevention & control; D014827:Vocal Cords / Q000000981:diagnostic imaging*; D055815:Young Adult