Our Summary

This research paper looks at an alternative way to check a patient’s voice before and after they have thyroid or parathyroid surgery. Traditionally, doctors use a method called indirect laryngoscopy (IDL) to look at the patient’s vocal cords. However, this procedure can potentially spread the COVID-19 virus around the room. As an alternative, some doctors have suggested using translaryngeal ultrasound (TLUS), which uses sound waves to create an image of the vocal cords and is safer because it doesn’t have the same risk of spreading the virus.

The researchers reviewed different scientific studies and found that TLUS can successfully visualize the vocal cords in many cases. Before surgery, TLUS was able to successfully see the vocal cords in anywhere from 50.6% to 100% of the cases. After surgery, this range was between 39.6% and 100%.

However, the success of TLUS can vary based on factors like the person doing the ultrasound, the patient’s age, and the patient’s gender. So while TLUS is a promising alternative to IDL, it seems to work best for young patients who have had uncomplicated surgery and whose voices sound normal during a clinical examination. This way, doctors can confirm the nerves in the larynx (voice box) are working properly, without the risk of spreading the virus.

FAQs

  1. What is the traditional method of checking a patient’s voice before and after thyroid or parathyroid surgery?
  2. How does the translaryngeal ultrasound (TLUS) method differ from the traditional method and why is it considered safer during the COVID-19 pandemic?
  3. What factors can affect the success of TLUS and who are the best candidates for this method?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vocal cord surgery is to follow the post-operative care instructions carefully to ensure proper healing and avoid complications. This may include rest, voice rest, avoiding strenuous activities, and following any prescribed medications or vocal therapy. It is also important to attend follow-up appointments to monitor progress and address any concerns. Additionally, practicing good vocal hygiene, such as staying hydrated and avoiding irritants like smoking, can help support vocal cord health and recovery.

Suitable For

Patients who are typically recommended vocal cord surgery include those with vocal cord paralysis, vocal cord nodules or polyps, laryngeal cancer, and other voice disorders. Additionally, patients who have undergone thyroid or parathyroid surgery may also be recommended for vocal cord surgery to assess the function of their vocal cords and ensure that they are functioning properly. In these cases, translaryngeal ultrasound (TLUS) may be a useful alternative to traditional methods of assessing vocal cord function before and after surgery.

Timeline

Before vocal cord surgery, a patient may experience symptoms such as hoarseness, vocal fatigue, difficulty swallowing, or a change in voice quality. They may undergo various tests and evaluations to determine the cause of their vocal cord issues, including a physical examination, laryngoscopy, and possibly imaging tests like an MRI or CT scan.

After vocal cord surgery, the patient may experience temporary hoarseness or changes in their voice quality as the vocal cords heal. They may need to rest their voice and follow specific vocal exercises or therapy to regain strength and function in their vocal cords. Follow-up appointments with their doctor or speech therapist may be necessary to monitor their progress and ensure proper healing.

Overall, the timeline for a patient before and after vocal cord surgery can vary depending on the individual’s specific condition, the type of surgery performed, and their overall health. It is important for patients to follow their doctor’s recommendations for pre-operative and post-operative care to achieve the best possible outcomes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vocal cord surgery include:

  1. What is the reason for recommending vocal cord surgery?
  2. What are the potential risks and complications associated with the surgery?
  3. How will the surgery affect my voice and speech?
  4. What is the expected recovery time and post-operative care plan?
  5. What alternative treatment options are available?
  6. How many times have you performed this type of surgery?
  7. What is the success rate of this surgery in terms of improving vocal cord function?
  8. Will I need any additional tests or evaluations before the surgery?
  9. How will you monitor my vocal cord function during and after the surgery?
  10. Are there any lifestyle changes or restrictions I should follow before and after the surgery?

Reference

Authors: Phung D, Fradet L, Riffat F, Novakovic D, Elliott MS, Nguyen K, Makeham J, Palme CE. Journal: ANZ J Surg. 2022 Mar;92(3):385-389. doi: 10.1111/ans.17530. Epub 2022 Feb 8. PMID: 35133056