title: A novel lateral-approach laryngeal ultrasonography for vocal cord evaluation.
abstract: BACKGROUND
  Laryngeal ultrasonography (LUS) is a new method of vocal cord (VC) evaluation in patients with risk of vocal cord palsy (VCP). The previously described anterior-approach LUS reportedly, however, has high failure rate of VC visualization in male patients. We devised a novel lateral-approach LUS to overcome this limitation.
  
  
  METHODS
  A total of 382 (82 male, 300 female) consecutive LUS and direct laryngoscopy (DL) examinations were performed on perioperative thyroidectomy and parathyroidectomy patients. The anterior-approach LUS was used for female patients whereas the lateral-approach LUS was used for male patients. Findings were cross-validated independently with DL examinations.
  
  
  RESULTS
  Both anterior and lateral LUS methods had 100% visualization rate (no failed visualization) with an overall sensitivity of 100% (23/23) and specificity of 99.2% (356/359) for VCP. Among the 300 female patients, 18 patients had VCP. Sensitivity and specificity of anterior-approach LUS were 100% (18/18) and 99.3% (280/282), respectively. Among the 80 male patients, 5 patients had VCP. Sensitivity and specificity of lateral-approach LU were 100% (5/5) and 98.7% (76/77), respectively.
  
  
  CONCLUSIONS
  The new LUS approach significantly enhances the visualization of vocal cords and, therefore, overall diagnostic efficacy of LUS in male patients.
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jung-Woo
authors.initials: JW
authors.lastname: Woo
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Mount Sinai Beth Israel Hospital, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hyunsuk
authors.initials: H
authors.lastname: Suh
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ra-Yeong
authors.initials: RY
authors.lastname: Song
authors.affiliation: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Joon-Hyop
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyeong Won
authors.initials: HW
authors.lastname: Yu
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Su-jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Boramae Medical Center, Seoul, Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Chai
authors.affiliation: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: June Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. Electronic address: kyueunlee@snu.ac.kr.
authors.forename: Kyu Eun
authors.initials: KE
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000009:adverse effects; D011300:Preoperative Care; D018570:Risk Assessment; D013965:Thyroidectomy / Q000009:adverse effects*; D014463:Ultrasonography; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D014827:Vocal Cords / Q000000981:diagnostic imaging* / Q000502:physiology; D055815:Young Adult