Our Summary

This research paper is about a new method to use ultrasound to check how well the vocal cords are moving. Ultrasounds are often used by doctors who specialize in hormones and hormone-related surgeries to look at the thyroid (a gland in your neck that makes hormones). They could also be helpful to see if the vocal cords are moving correctly. However, previous studies showed that it’s often difficult to see the vocal cords using ultrasound.

To help with this, the researchers created a new way to use ultrasound to check the vocal cords by looking at the movement of the arytenoid (a pair of small cartilages in the larynx or voice box) from the side.

The study involved 188 people, including 23 who had vocal cord paralysis (unable to move the vocal cords) and 13 with vocal cord paresis (weakness in the vocal cords). The researchers used the usual way to check the vocal cords using ultrasound, and also tested the new method.

They found that the usual method could see the vocal cords in about 70% of cases, while the new method could see the arytenoid in almost all cases (98.4%). The new method could see all patients with vocal cord paralysis or paresis, and correctly identified all patients with vocal cord paralysis. Only one patient with vocal cord paresis was not correctly identified. The old method could see about 58% of patients with vocal cord paralysis or paresis. There were no false-positive cases in either method (i.e., the methods did not incorrectly identify anyone as having a problem when they did not).

In conclusion, the new method improved the ability to see vocal cord movement with ultrasound, which suggests it could be a helpful way to check for vocal cord paralysis using ultrasound.

FAQs

  1. What is the new ultrasonographic procedure proposed for assessing vocal cord movement?
  2. How does the novel lateral vertical procedure compare to the conventional middle transverse procedure in terms of visualization rate?
  3. Can the lateral vertical procedure detect all cases of vocal cord paralysis and paresis?

Doctor’s Tip

After vocal cord surgery, it is important to follow all post-operative care instructions provided by your doctor. This may include avoiding speaking or whispering for a certain period of time, staying hydrated, and avoiding strenuous activities. It is also important to attend all follow-up appointments to monitor your progress and ensure proper healing. If you experience any unexpected symptoms or complications, be sure to contact your doctor immediately.

Suitable For

Patients who are typically recommended vocal cord surgery include those with vocal cord paralysis or paresis, which can result in hoarseness, difficulty speaking or swallowing, and breathing problems. Other conditions that may warrant vocal cord surgery include vocal nodules, polyps, or cysts, which can cause voice changes or difficulty producing sound. Additionally, patients with laryngeal cancer or other tumors affecting the vocal cords may also require surgery to remove the growth and preserve vocal function.

Timeline

Before vocal cord surgery:

  1. Patient experiences symptoms such as hoarseness, difficulty breathing or swallowing, or a weak voice.
  2. Patient undergoes a thorough examination by an otolaryngologist, which may include laryngoscopy and imaging studies.
  3. Otolaryngologist determines that vocal cord surgery is necessary to address the underlying issue.

After vocal cord surgery:

  1. Patient undergoes vocal cord surgery, which may involve procedures such as vocal cord injection, medialization laryngoplasty, or vocal cord repositioning.
  2. Patient is monitored closely post-surgery for any complications and to ensure proper healing.
  3. Patient undergoes voice therapy to help improve vocal function and strengthen the vocal cords.
  4. Patient may experience improvements in voice quality and function over time as the vocal cords heal and the underlying issue is addressed.

What to Ask Your Doctor

  1. What is the success rate of vocal cord visualization using ultrasonography for this procedure?
  2. How does the novel lateral vertical procedure differ from the conventional middle transverse procedure in terms of assessing vocal cord movement?
  3. What are the potential benefits of using ultrasonography to assess vocal cord movement compared to other diagnostic techniques?
  4. What are the risks or limitations associated with this procedure?
  5. How will the results of the ultrasonographic assessment impact my treatment plan for vocal cord paralysis or paresis?
  6. Are there any specific preparations or precautions I need to take before undergoing this procedure?
  7. How experienced are you and your team in performing ultrasonographic assessment of vocal cord movement?
  8. What are the potential complications or side effects of vocal cord surgery, and how likely are they to occur?
  9. What is the expected recovery time and outcome following vocal cord surgery?
  10. Are there any alternative treatments or therapies that I should consider before proceeding with surgery?

Reference

Authors: Fukuhara T, Donishi R, Matsuda E, Koyama S, Fujiwara K, Takeuchi H. Journal: World J Surg. 2018 Jan;42(1):130-136. doi: 10.1007/s00268-017-4151-z. PMID: 28752427