Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis

Recurrent laryngeal nerve injury is an important complication following thyroid and parathyroid surgery. Recently, Transcutaneous laryngeal ultrasound (TLUSG) has emerged as a non-invasive alternative to laryngoscopic examination for vocal cord (VC) assessment. The aim of the systematic review and m...

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Autores principales:	Agastya Patel, Piotr Spychalski, Aleksander Aszkiełowicz, Bogusław Mikaszewski, Jarek Kobiela
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	transcutaneous laryngeal ultrasonography laryngoscopy vocal cord paralysis thyroidectomy diagnostic accuracy Medicine R
Acceso en línea:	https://doaj.org/article/148b48bbfe7b4379a08761cc734522bc
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spelling	oai:doaj.org-article:148b48bbfe7b4379a08761cc734522bc2021-11-25T18:02:23ZTranscutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis10.3390/jcm102253932077-0383https://doaj.org/article/148b48bbfe7b4379a08761cc734522bc2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5393https://doaj.org/toc/2077-0383Recurrent laryngeal nerve injury is an important complication following thyroid and parathyroid surgery. Recently, Transcutaneous laryngeal ultrasound (TLUSG) has emerged as a non-invasive alternative to laryngoscopic examination for vocal cord (VC) assessment. The aim of the systematic review and meta-analysis was to determine its diagnostic accuracy in reference to laryngoscopy. It was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, Scopus, Cochrane library and Web of Science databases were searched to identify relevant articles. Sixteen studies were included in the review. Pooled diagnostic accuracy was calculated based on weighted arithmetic mean and plotting forest plot. The pooled visualization rate was 86.28% and 94.13% preoperatively and postoperatively, respectively. The respective pooled sensitivity and specificity was 78.48% and 98.28%, and 83.96% (CI 95%: 77.24–88.50%) and 96.15% (CI 95%: 95.24–96.88%). The diagnostic accuracy improved if transverse and lateral approaches, and valsalva maneuver were utilized. Male gender and older age were the most crucial risk factors for VC non-visualization. TLUSG is an efficacious screening tool for vocal cord palsy due to its high sensitivity. It is likely to prevent unnecessary laryngoscopic examination in around 80% of patients, with the potential for becoming a gold standard for specific (female/young) patient cohort through assimilative modifications use, increasing expertise and development of objective measurements in the future.Agastya PatelPiotr SpychalskiAleksander AszkiełowiczBogusław MikaszewskiJarek KobielaMDPI AGarticletranscutaneous laryngeal ultrasonographylaryngoscopyvocal cord paralysisthyroidectomydiagnostic accuracyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5393, p 5393 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	transcutaneous laryngeal ultrasonography laryngoscopy vocal cord paralysis thyroidectomy diagnostic accuracy Medicine R
spellingShingle	transcutaneous laryngeal ultrasonography laryngoscopy vocal cord paralysis thyroidectomy diagnostic accuracy Medicine R Agastya Patel Piotr Spychalski Aleksander Aszkiełowicz Bogusław Mikaszewski Jarek Kobiela Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis
description	Recurrent laryngeal nerve injury is an important complication following thyroid and parathyroid surgery. Recently, Transcutaneous laryngeal ultrasound (TLUSG) has emerged as a non-invasive alternative to laryngoscopic examination for vocal cord (VC) assessment. The aim of the systematic review and meta-analysis was to determine its diagnostic accuracy in reference to laryngoscopy. It was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, Scopus, Cochrane library and Web of Science databases were searched to identify relevant articles. Sixteen studies were included in the review. Pooled diagnostic accuracy was calculated based on weighted arithmetic mean and plotting forest plot. The pooled visualization rate was 86.28% and 94.13% preoperatively and postoperatively, respectively. The respective pooled sensitivity and specificity was 78.48% and 98.28%, and 83.96% (CI 95%: 77.24–88.50%) and 96.15% (CI 95%: 95.24–96.88%). The diagnostic accuracy improved if transverse and lateral approaches, and valsalva maneuver were utilized. Male gender and older age were the most crucial risk factors for VC non-visualization. TLUSG is an efficacious screening tool for vocal cord palsy due to its high sensitivity. It is likely to prevent unnecessary laryngoscopic examination in around 80% of patients, with the potential for becoming a gold standard for specific (female/young) patient cohort through assimilative modifications use, increasing expertise and development of objective measurements in the future.
format	article
author	Agastya Patel Piotr Spychalski Aleksander Aszkiełowicz Bogusław Mikaszewski Jarek Kobiela
author_facet	Agastya Patel Piotr Spychalski Aleksander Aszkiełowicz Bogusław Mikaszewski Jarek Kobiela
author_sort	Agastya Patel
title	Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis
title_short	Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis
title_full	Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis
title_fullStr	Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis
title_full_unstemmed	Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis
title_sort	transcutaneous laryngeal ultrasound for vocal cord paralysis assessment in patients undergoing thyroid and parathyroid surgery—a systematic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/148b48bbfe7b4379a08761cc734522bc
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Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery—A Systematic Review and Meta-Analysis

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