Our Summary

In this research, scientists studied the use of vocal cord ultrasonography (VCUS) as an alternative to flexible laryngoscopy (FL) in assessing the movement of the true vocal cords (TVC) in patients before surgery. FL is a common procedure where a flexible tube with a light and a camera on the end is used to examine the voice box. VCUS, on the other hand, is a non-invasive method which uses sound waves to create images of the vocal cords.

The study involved 194 patients who needed to have their vocal cords checked before surgery. The patients were divided into two groups. The first group of 52 patients had FL regardless of their VCUS results. The second group of 142 patients only had FL if the VCUS results were not satisfactory.

The results showed that VCUS was able to successfully visualise the vocal cords in 85% of the patients. It was found to be more effective in women and in patients without a specific type of hardening in the thyroid cartilage. Importantly, VCUS identified all cases of paralyzed vocal cords.

In the second group, 76% of patients had satisfactory VCUS results, meaning they could avoid the invasive FL procedure. For the remaining 24% where VCUS was not satisfactory, some had to proceed with FL due to various reasons such as poor visualisation of the vocal cords, abnormal vocal cord movement, the need for additional confirmation, or a previous need for FL.

In conclusion, the study found that VCUS could be a useful alternative to FL in most cases, offering a non-invasive method to check the vocal cords safely and effectively. This could potentially change the preoperative practices of surgeons, reducing the need for the more invasive FL procedure.

FAQs

  1. What is the purpose of vocal cord ultrasonography (VCUS) in preoperative procedures?
  2. How accurate is VCUS in identifying true vocal cord paralysis?
  3. Can VCUS replace the need for flexible laryngoscopy (FL) in preoperative procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vocal cord surgery is that vocal cord ultrasonography (VCUS) can be a useful and noninvasive method to confirm vocal cord mobility before surgery. This can help avoid unnecessary procedures like flexible laryngoscopy in some cases. Make sure to discuss with your doctor about the best options for preoperative evaluation.

Suitable For

Patients who are typically recommended vocal cord surgery include those with previous neck operations, suspected vocal cord dysfunction, vocal cord paralysis, abnormal vocal cord mobility, or other indications for preoperative flexible laryngoscopy. Additionally, patients who may benefit from vocal cord surgery are those who have difficulty speaking, breathing, or swallowing due to vocal cord issues.

Timeline

Before vocal cord surgery:

  1. Patient is scheduled for vocal cord surgery due to suspected vocal cord dysfunction or previous neck operations.
  2. Patient undergoes vocal cord ultrasonography (VCUS) as the initial study to confirm true vocal cord (TVC) mobility.
  3. VCUS visualizes TVC/arytenoids in 85% of patients, with higher visualization rates in women and patients without thyroid cartilage calcification.
  4. VCUS accurately predicts all cases of paralyzed TVC.
  5. In some cases, patients may still require a flexible laryngoscopy (FL) if VCUS results are unsatisfactory.

After vocal cord surgery:

  1. 76% of patients with adequate VCUS results avoid preoperative FL and proceed directly to surgery.
  2. For the remaining 24% of patients with inadequate VCUS results, further diagnostic tests may be necessary before surgery.
  3. In cases where preoperative FL is still required, it may be due to a lack of TVC visualization, abnormal TVC mobility, or the need for additional confirmations.
  4. Overall, VCUS has been shown to be a noninvasive and sensitive method for assessing TVC mobility and has reduced the need for preoperative FL in the majority of patients undergoing vocal cord surgery.

What to Ask Your Doctor

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

  1. What is the purpose of the surgery?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time and post-operative care?
  4. What type of anesthesia will be used during the surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. What is the success rate of this type of surgery for my condition?
  7. Are there alternative treatments available for my condition?
  8. Will I need any additional tests or evaluations before the surgery?
  9. How experienced is the surgeon in performing vocal cord surgery?
  10. What should I expect in terms of my voice and swallowing function after the surgery?

Reference

Authors: Carneiro-Pla D, Solorzano CC, Wilhelm SM. Journal: Surgery. 2016 Jan;159(1):58-63. doi: 10.1016/j.surg.2015.06.067. Epub 2015 Oct 23. PMID: 26603853