Transcutaneous laryngeal ultrasound for long-term voice function and vocal fold evaluation after thyroidectomy: a prospective study.

Background: Transcutaneous laryngeal ultrasound (TLUSG) has come up as a practical alternative to laryngoscopy for the diagnosis of vocal fold palsy (VFP), as it's non-invasive and capable for dynamic real-time evaluation.

Aims/objectives: To assess the features of the vocal cord (VF) recovery process and the diagnostic significance of TLUSG for VFP during long-term follow-up on patients with voice disorders post-thyroidectomy.

Material and methods: Fifty-seven patients with voice impairment following thyroidectomy were enrolled. The image features of VFs and the voice handicap index (VHI) scores were recorded at various intervals after surgery. Laryngoscopy was performed for comparison.

Results: 75.4%(43/57) patients recovered voice function as assessed by VHI, 41 (71.9%) patients demonstrated recovery by TLUSG. Eighteen patients underwent laryngoscopy, and 14 were identified as VFP. The ultrasonic images of VFP presented with different manifestations at different periods after thyroidectomy. The diagnostic accuracy of TLUSG increased from 77.8% to 88.9% over time, whereas that of VHI exhibited a decrease. TLUSG and Laryngoscope were highly consistent (κ = 0.679), as were the evaluations of two physicians.

Conclusions and significance: The TLUSG is an effective alternative to laryngoscopy in patients with vocal dysfunction following thyroidectomy.