Laryngeal ultrasound in diagnosis of vocal cord palsy: An underutilized tool?

Abstract

Background: Despite the prevalence of ultrasonography in medical practice, its use in laryngeal disorders appears underutilized. It provides a simple, easy, cheap and non-invasive method to diagnose vocal cord palsy in real time, dynamic 2 or 3-dimensional image mode. It can be an alternative diagnostic tool where flexible fibreoptic laryngoscopy is limited by an uncooperative patient, xylocaine sensitivity or where stroboscopy is not available due to cost restraints. Especially it is useful in the preoperative workup of a patient undergoing thyroid surgery. Aims: The present study evaluates the accuracy of ultrasonography in diagnosis of vocal cord palsy in 25 patients. We have used fibreoptic laryngoscopy purely as a comparative tool for purposes of this study. Materials and Methods: It was a prospective study carried out in 25 patients presenting with hoarseness. Patients underwent laryngeal ultrasound followed by flexible fibreoptic laryngoscopy. Results: We were able to accurately diagnose vocal cord palsy by ultrasound in all but two patients where the examination was limited by extensive laryngeal cartilage calcification. Discussion and Conclusion: There is every evidence to suggest that ultrasonography has a place in diagnosis of vocal cord palsies. It is easy, cheap, available, and non-invasive. It is a useful tool where fibreoptic laryngoscopy is limited by an uncooperative patient and where strobolaryngoscopy is not available. Further study and more familiarity would extend its use to other laryngeal disorders.