Preoperative ultrasonography assessment of vocal cord movement during thyroid and parathyroid surgery.
BACKGROUND
Preoperative detection of vocal cord palsy is important in thyroid and parathyroid surgery. However, routine fiberoptic laryngoscopy may bring patients unnecessary discomfort. The aim of this study was to determine the feasibility of using surgeon-performed ultrasonography (US) as a screening tool for preoperative assessment of vocal cord movement.


METHODS
In the first phase, patients had both laryngoscopic and US examination before surgery. In the second phase, patients had US evaluation first. Those with abnormal vocal cord movement on US, with invisible cord movement, or presenting with significant vocal symptoms underwent laryngeal examination.


RESULTS
In all, 93 (82 %) of 114 patients had successful US evaluation of vocal cord movement during the first phase. Two of them had vocal cord paralysis. In the second phase, vocal cord movement could be evaluated by US in 349 (84 %) of 415 patients. Four patients with abnormal movement were confirmed to have vocal cord palsy by laryngoscopy. None of 46 symptomatic patients with normal movement on US had vocal cord palsy. One other patient whose cord movement could not be seen by US had vocal cord palsy on laryngoscopic examination.


CONCLUSIONS
Surgeon-performed US appears to be a relatively accurate method for assessing vocal cord movement in the preoperative setting. It can be used to select patients to undergo laryngoscopic examination before thyroidectomy and parathyroidectomy.
Department of Surgery, Mackay Memorial Hospital, 92, Sec. 2, Zhongshan N. Road, Taipei, 10449, Taiwan.
Shih-Ping
SP
Cheng
Jie-Jen
JJ
Lee
Tsang-Pai
TP
Liu
Kuo-Sheng
KS
Lee
Chien-Liang
CL
Liu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D016105:Parathyroidectomy; D011300:Preoperative Care; D011446:Prospective Studies; D013965:Thyroidectomy; D014463:Ultrasonography; D014827:Vocal Cords / Q000000981:diagnostic imaging* / Q000502:physiology*; D055815:Young Adult