Transcutaneous Laryngeal Ultrasonography for the Assessment of Laryngeal Function After Thyroidectomy: A Review

Ear, Nose, & Throat Journal

da Costa, B. O. I., Rodrigues, D. S. B., et al. (2021).

Ear, Nose, & Throat Journal, 100(6), 439-446.

This systematic review investigates the use of transcutaneous laryngeal ultrasonography (TLUSG) to assess laryngeal functioning in individuals who have undergone a partial or total thyroidectomy.

No funding received

January 2008 to July 2018

Published Portuguese-, English-, and Spanish-language studies

8

For individuals who have undergone partial or total thyroidectomy, seven studies comparing transcutaneous laryngeal ultrasonography (TLUSG) to flexible or rigid fiberscopes and one study comparing TLUSG to videostroboscopy found TLUSG to be "a viable, noninvasive, and useful method to assess laryngeal function" (p. 445). Several studies investigated the diagnostic accuracy of TLUSG. <ul> <li>For assessing vocal fold immobility, two studies reported the tool to be insufficient for definitive diagnosis of vocal fold paralysis "with a sensitivity of 33%, a specificity of 95%, a positive predictive value of 42%, and a negative predictive value of 89%" (p. 444).</li> <li>For identifying vocal fold immobility in an immediate post-operative setting, one study reported a sensitivity of 93.3% and a specificity of 96.1%.</li> <li>For identifying patients who are candidates for direct laryngoscopy 7-10 days after thyroidectomy, one study found a sensitivity of 93.3% and a specificity of 97.8%.</li> <li>For assessing pre- and post-thyroidectomy vocal fold function, one study reported a sensitivity of 93.3%, a specificity of 97.8%, a positive predictive value of 77.8%, and a negative predictive value of 99.4%.</li> </ul> The authors of this review conclude that "it is not possible to confirm that TLUSG can replace direct flexible laryngoscopy for the diagnosis of vocal fold immobility" (p. 445). Additional research on the assessment accuracy of TLUSG is warranted.