Ultrasonography diagnostic validity in structural and functional laryngeal disorders

Abstract

Abstract Background The diagnostic approach for patients with laryngeal lesions differs among otolaryngologists. Indirect laryngoscopy, flexible fibrooptic laryngoscopy, CT, and MRI are all modalities used for diagnosis. Ultrasonography is noninvasive, non-irradiating, and safe. The availability, affordability, and usability of portable ultrasound units have undergone dramatic improvements. It is well tolerated by patients, dynamic technique that can be performed easily in phonation, quickly performed, and allows for photo-documentation. Our objective is to evaluate the laryngeal ultrasound as a diagnostic tool to evaluate different laryngeal structure as regard laryngeal dynamics (range and abnormality), and anatomic structures. This prospective study was carried out on individuals in “blinded for peer review” hospitals. They were divided into group I (healthy volunteers), group II (unilateral vocal fold paralysis), and group III (patients underwent vertical hemilaryngectomies). All patients were subjected to full history taking, detailed head and neck examination, and fibrooptic nasopharyngolaryngoscopy then all patients underwent laryngeal sonographic examination. The photos were analyzed to identify various laryngeal structures and to measure glottic areas and inter-arytenoid distances. Results After recognition of laryngeal anatomic details and different measurements, we found that the percent of change in length and area were much less in group III than group I or II. Another important finding is that glottic area during respiration is related significantly to interarytenoid length during respiration with a statistically significant regression coefficient. Conclusion Laryngeal ultrasound is a valid diagnostic tool for imaging laryngeal structures and measuring various distances and areas inside the larynx. It is recommended to consider ultrasonography as a reliable imaging modality, and at least a useful adjunct to endoscopy when identification of airway patency, vocal fold mobility, or structural alterations is suspected. To our best knowledge, this study may contain a hitherto undescribed correlation between inter-arytenoid length and glottic area.

Keywords

• Ultrasonography
• Cord paralysis
• Laryngeal imaging
• Airway