Validation of ultrasound as a diagnostic tool to assess vocal cord motion in an animal feasibility study

Karuna Dewan, Merry E. Sebelik, John Boughter, Courtney B. Shires

Research output: Contribution to journalArticle

Abstract

Background: Post-thyroidectomy dysphonia can result from recurrent laryngeal nerve (RLN) injury. Confirmation of postoperative recurrent nerve function has prompted many surgeons to advocate laryngoscopic examination. Indirect and flexible laryngoscopy permit visualization of vocal cord motion, but not all thyroid surgeons are skilled in these techniques. Indirect laryngoscopy has a significant failure rate due to gag reflexes or anatomical obstruction. Flexible fiberoptic laryngoscopy, the current gold standard, allows reliable visualization of the cords, but perioperative examination is not always feasible for lack of equipment or training. Recent studies suggest vocal fold ultrasound as an alternative to flexible laryngoscopy. It offers the advantages of being non-invasive and painless without radiation exposure or sedation. Whereas ultrasound has been compared to laryngoscopy in the clinical setting, there remains a need for correlation of laryngeal ultrasound results with known neurophysiology in the normal and injured state. An animal model was proposed that reproduces neck surgery-associated recurrent nerve injury. The model allowed simultaneous recording of laryngeal endoscopy and transcutaneous high-resolution ultrasound during stimulation of intact and injured RLNs. Methods: One RLN was injured in each of 4 rats. Rats were kept anesthetized during the fiberoptic examination and laryngeal ultrasound procedures. Following surgery and subsequent imaging the rats were given a lethal anesthetic dose. Results of both imaging modalities were compared to the presence or absence of neuromuscular action potential following stimulation of the recurrent nerve. Results: The investigators observed a 100% correlation between endoscopic and ultrasonographic assessments. Conclusions: This study validated the clinical use of diagnostic ultrasound in vocal cord dysfunction in a rodent model.

Original languageEnglish (US)
Pages (from-to)433-439
Number of pages7
JournalGland Surgery
Volume7
Issue number5
DOIs
StatePublished - Oct 1 2018

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Laryngoscopy
Vocal Cords
Feasibility Studies
Vocal Cord Dysfunction
Recurrent Laryngeal Nerve Injuries
Recurrent Laryngeal Nerve
Dysphonia
Neurophysiology
Thyroidectomy
Endoscopy
Action Potentials
Reflex
Anesthetics
Rodentia
Ultrasonography
Thyroid Gland
Neck
Animal Models
Research Personnel
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Surgery

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Validation of ultrasound as a diagnostic tool to assess vocal cord motion in an animal feasibility study. / Dewan, Karuna; Sebelik, Merry E.; Boughter, John; Shires, Courtney B.

In: Gland Surgery, Vol. 7, No. 5, 01.10.2018, p. 433-439.

Research output: Contribution to journalArticle

Dewan, Karuna ; Sebelik, Merry E. ; Boughter, John ; Shires, Courtney B. / Validation of ultrasound as a diagnostic tool to assess vocal cord motion in an animal feasibility study. In: Gland Surgery. 2018 ; Vol. 7, No. 5. pp. 433-439.
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