title: Feasibility of surgeon-performed transcutaneous vocal cord ultrasonography in identifying vocal cord mobility: A multi-institutional experience.
abstract: BACKGROUND
  Transcutaneous vocal cord ultrasonography (TVCUS) is a noninvasive study used to identify true vocal cord (TVC) mobility. Its sensitivity in predicting TVC paralysis when compared with indirect flexible laryngoscopy (IFL) ranges from 62 to 93%. This study aimed to evaluate the feasibility of surgeon-performed TVCUS in assessing TVC mobility in the outpatient setting.
  
  
  METHODS
  At 5 institutions, 510 consecutive patients underwent 887 TVCUS performed by 8 surgeons during initial surgical evaluation. IFL was obtained in selected patients. TVCUS was repeated during the first postoperative visit, and IFL was obtained only when judged necessary. Clinical parameters were collected and later correlated with TVC visualization.
  
  
  RESULTS
  TVC visualization was possible in 688 of 887 TVCUS (77%); visibility ranged from 41 to 86% among performing surgeons. IFL was done in 81 patients (16%) and TVCUS predicted TVC paralysis in all cases when TVC were seen. TVC visualization was possible more often in females than males (83% vs 17%; P < .0005) and in patients without thyroid cartilage calcification than those with calcification (83% vs 42%; P < .0005).
  
  
  CONCLUSIONS
  Experienced surgeon-ultrasonographers can use TVCUS to visualize TVC in most female patients and less so in males. TVCUS is highly sensitive, but operator dependent. This study demonstrates the feasibility of TVCUS and directs further attention to defining its optimal role in assessment of TVC mobility.
authors.affiliation: Medical University of South Carolina, Charleston, SC. Electronic address: carneiro@musc.edu.
authors.forename: Denise
authors.initials: D
authors.lastname: Carneiro-Pla
authors.affiliation: University of Michigan, Ann Arbor, MI.
authors.forename: Barbra S
authors.initials: BS
authors.lastname: Miller
authors.affiliation: University Hospitals/Case Medical Center, Cleveland, OH.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wilhelm
authors.affiliation: Oregon Health Sciences University, Portland, OR.
authors.forename: Mira
authors.initials: M
authors.lastname: Milas
authors.affiliation: University of Michigan, Ann Arbor, MI.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Gauger
authors.affiliation: University of Michigan, Ann Arbor, MI.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cohen
authors.affiliation: University of Michigan, Ann Arbor, MI.
authors.forename: David T
authors.initials: DT
authors.lastname: Hughes
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Solorzano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000009:adverse effects / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D066231:Surgeons; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods*; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging* / Q000601:surgery; D014827:Vocal Cords / Q000000981:diagnostic imaging* / Q000502:physiology; D055815:Young Adult