Lateral laryngeal ultrasound for vocal cord evaluation in neck surgery: A mutually double-blind comparative study with laryngoscopy

Abstract

Background: Vocal cord dysfunction is a significant complication after thyroid surgery, typically evaluated with invasive laryngoscopy. This study assessed diagnostic accuracy and feasibility of lateral laryngeal ultrasound as a noninvasive alternative. Methods: In a prospective, double-blind study at Gyeongsang National University Changwon Hospital (February 2016 to June 2023), 718 patients underwent preoperative and postoperative vocal cord assessment using laryngoscopy and lateral laryngeal ultrasound. Both patients and assessors were blinded to the counterpart modality. Sensitivity, specificity, and visualization rates were analyzed. Results: Lateral laryngeal ultrasound visualized vocal cords in 99.6% of cases (715/718), with 100% sensitivity and 99.5% specificity for detecting vocal cord paralysis compared with laryngoscopy. No adverse effects were reported. Conclusions: Lateral laryngeal ultrasound is a reliable, noninvasive tool for perioperative vocal cord evaluation, offering a patient-friendly alternative that may reduce the need for laryngoscopy in thyroid surgery