A prospective study evaluating the feasibility and accuracy of very early postoperative translaryngeal ultrasonography in the assessment of vocal cord function after neck surgery.
Aged
Early Diagnosis
Endosonography
/ methods
Feasibility Studies
Female
Humans
Laryngoscopy
/ statistics & numerical data
Male
Middle Aged
Parathyroidectomy
/ adverse effects
Postoperative Complications
/ diagnosis
Prospective Studies
Recurrent Laryngeal Nerve Injuries
/ diagnosis
Thyroidectomy
/ adverse effects
Time Factors
Vocal Cord Paralysis
/ diagnosis
Vocal Cords
/ diagnostic imaging
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
31
01
2020
revised:
04
03
2020
accepted:
10
03
2020
pubmed:
5
6
2020
medline:
27
4
2021
entrez:
5
6
2020
Statut:
ppublish
Résumé
Early recognition of postoperative vocal cord palsy enhances postoperative care. Translaryngeal ultrasonography can assess vocal cord function accurately and noninvasively, but it is unclear whether it is feasible or accurate when done immediately after extubation in the recovery room owing to possible interference from laryngeal swelling. This study assessed the feasibility and accuracy of translaryngeal ultrasonography in this setting. Consecutive patients undergoing neck operations were subjected to translaryngeal ultrasonography and flexible direct laryngoscopy 1 day before and day 7 after thyroidectomy and parathyroidectomy. Translaryngeal ultrasonography was performed early in the recovery room immediately after extubation in the operating room. A standardized assessment protocol was used. Patient parameters were compared between those with assessable and unassessable vocal cords. Sixty-five patients (91 recurrent laryngeal nerves-at-risk) were analyzed after excluding 2 male patients who failed preoperative translaryngeal ultrasonography. Fifty-six patients underwent thyroidectomy and 9 parathyroidectomy. The median age (range) was 57 (46-69); 44 (68%) were women. Sixty-one patients (94%) had assessable bilateral vocal cords on translaryngeal ultrasonography in the recovery room. Translaryngeal ultrasonography in the recovery room findings corresponded completely with day-7 findings on direct laryngoscopy. Long operative time was associated with nonassessable vocal cords on translaryngeal ultrasonography in the recovery room (P = .026). Very early postoperative translaryngeal ultrasonography in the recovery room after neck surgery is highly feasible and accurate. Long operative time may hinder the use of translaryngeal ultrasonography in the recovery room.
Sections du résumé
BACKGROUND
Early recognition of postoperative vocal cord palsy enhances postoperative care. Translaryngeal ultrasonography can assess vocal cord function accurately and noninvasively, but it is unclear whether it is feasible or accurate when done immediately after extubation in the recovery room owing to possible interference from laryngeal swelling. This study assessed the feasibility and accuracy of translaryngeal ultrasonography in this setting.
METHODS
Consecutive patients undergoing neck operations were subjected to translaryngeal ultrasonography and flexible direct laryngoscopy 1 day before and day 7 after thyroidectomy and parathyroidectomy. Translaryngeal ultrasonography was performed early in the recovery room immediately after extubation in the operating room. A standardized assessment protocol was used. Patient parameters were compared between those with assessable and unassessable vocal cords.
RESULTS
Sixty-five patients (91 recurrent laryngeal nerves-at-risk) were analyzed after excluding 2 male patients who failed preoperative translaryngeal ultrasonography. Fifty-six patients underwent thyroidectomy and 9 parathyroidectomy. The median age (range) was 57 (46-69); 44 (68%) were women. Sixty-one patients (94%) had assessable bilateral vocal cords on translaryngeal ultrasonography in the recovery room. Translaryngeal ultrasonography in the recovery room findings corresponded completely with day-7 findings on direct laryngoscopy. Long operative time was associated with nonassessable vocal cords on translaryngeal ultrasonography in the recovery room (P = .026).
CONCLUSION
Very early postoperative translaryngeal ultrasonography in the recovery room after neck surgery is highly feasible and accurate. Long operative time may hinder the use of translaryngeal ultrasonography in the recovery room.
Identifiants
pubmed: 32493615
pii: S0039-6060(20)30169-0
doi: 10.1016/j.surg.2020.03.025
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
191-196Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.