Early report of ultrasound vocal cord assessment for patients undergoing cervicotomy
James Kirkby-Bott, Amanda Mortier, Gavin Royle & K Dewbury
Introduction: The majority of dedicated endocrine surgery centres in the UK and abroad routinely perform pre-operative vocal cord checks prior to cervicotomy. Ultrasound scanning is increasingly used as routine imaging in the work up of patients being assessed with thyroid and parathyroid disease. We report on the additional use of USS as a method of performing pre-operative vocal cord checks.
Method: We report the early results on 32 patients undergoing USS as an assessment of thyroid status, USS guided FNAC and assessment of lymph node status prior to thyroidectomy. In addition to this all patients had vocal cord function assessed. Whilst in the supine position the vocal folds were assessed during quiet respiration and phonation. The patients then underwent naso-endoscopy to validate the USS vocal cord findings.
Results: Thirty-two patients (26 female 6 male) underwent thyroid surgery. None had thyroid cancer. Thirty patients vocal folds were seen on USS to move normally; this corresponded with normal vocal cord movement on naso-endoscopy. Two patients had calcified thyroid cartilage making USS interpretation too difficult to be reliable.
Conclusion: USS assessment of vocal cord function appears to be possible and feasible in the great majority of cases. Greater numbers are needed to confirm the accuracy of USS in abnormal vocal cord movement and the proportion of patients in whom USS vocal cord assessment is successfully undertaken. However these findings would suggest it is a useful means of assessing vocal cord function prior to cervicotomy in most patients.