Publication:

The utility of surgeon performed transcutaneous laryngeal ultrasound for the assessment of vocal cords in post-thyroidectomy patients

Background Post-thyroidectomy vocal cord palsy is a significant procedure associated complication and a notable contributor for medico-legal litigation. The standard technique for vocal cord evaluation and the most commonly used tool is direct laryngoscopy. Endocrine surgeons generally address the patients to otolaryngologist for laryngoscopy, leading to extra expense and time loss. Laryngoscopy causes patient annoyance and could potentially contribute to poor patient compliance. Ultrasonography is a non-invasive technique that is regularly used by endocrine surgeons to examine the thyroid region.

Methods A prospective study conducted on patients who underwent thyroidectomy between September 2016 and August 2017 at endocrine surgery department in a tertiary care institute (South India), Surgeon performed ultrasound (SPU) and Video laryngoscopy (VDL) was performed before and after elective thyroidectomy.

Results 155 patients who consented were categorized in the study, 2 of the patients included in the study had preoperative vocal cord palsy and 12 of them had unilateral postoperative vocal cord palsy detected using VDL. In general, the postoperative vocal cord palsy rate was 6.45%. Postoperative SPU was ineffective in assessing vocal cords in 16(10.32%) of patients. SPU had a sensitivity of 83.33% and negative predictive value of 97.90%, for the visualization of vocal cords in the postoperative period.

Conclusions SPU is convenient and non-invasive technique which could provide our speciality with cheap yet powerful diagnostic tool for vocal cord assessment in post-thyroidectomy patients and can potentially decrease the requirement of difficult and cumbersome VDL.