Role of high resolution laryngeal ultrasound in evaluation of laryngeal pathologies in children.

Abstract

Introduction: The larynx is a crucial and vital structure present in the neck, having a key role in protection of lower airways, phonation and breathing. Life-threatening breathing issues can arise in newborns with laryngeal abnormalities. The most common symptom of laryngeal obstruction is stridor. A child with stridor usually causes a great deal of anxiety for the caregiver, so the medical practitioner should treat them as a clinical priority. The standard assessment of laryngeal abnormalities currently involves direct laryngoscopy and cross-sectional imaging (either CT or MRI) but rarely ultrasound. Ultrasound offers many advantages such as easily available, non invasive, affordable, lack of radiation, less time consuming and ability to do real-time imaging (with video for dynamic assessment). This study aims to know the diagnostic potential of laryngeal ultrasound in evaluation of laryngeal pathologies.

Methods: A hospital based diagnostic study was carried on 50 children who had complaints of stridor, weak cry and hoarseness of voice. First LUS was performed and then ANL/MLB was performed and diagnosis was made. Findings of LUS were correlated with final diagnosis made on flexible nasopharyngolaryngoscopy /MLB.

Results: 50 children were enrolled in the study 26(52%) males and 24(48%). The median age was 3.50 months.LUS was performed without sedation in all patients.The sensitivity and specificity of LUS was 90.9% and 82.3% respectively.The PPV and NPV of LUS was 90.9%and 82.3% respectively.

Conclusion: LUS is a promising tool in the evaluation of laryngeal pathologies. It is readily available and can be used in centers where flexible laryngoscopy is not available. It can be used as a alternative to diagnose laryngomalacia and vocal fold paresis/paralysis. There is no radiation exposure, and it is easily available, portable, and economical.