Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists

Background: Flexible fibreoptic laryngoscopy (FFL) is currently the gold standard for assessment of true vocal cord (TVC) mobility but is invasive and not without risk. The aim of this study was to determine the accuracy of an application-based translaryngeal ultrasonography (TLUS) as a screening to...

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Main Authors: Divya P. Ramyead, Fiona Kabagenyi, Sandhia Padayachee, Marc Jordaan, Shazia Peer
Format: Article
Language:English
Published: AOSIS 2024-03-01
Series:Journal of the Colleges of Medicine of South Africa
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Online Access:https://jcmsa.org.za/index.php/jcmsa/article/view/59
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author Divya P. Ramyead
Fiona Kabagenyi
Sandhia Padayachee
Marc Jordaan
Shazia Peer
author_facet Divya P. Ramyead
Fiona Kabagenyi
Sandhia Padayachee
Marc Jordaan
Shazia Peer
author_sort Divya P. Ramyead
collection DOAJ
description Background: Flexible fibreoptic laryngoscopy (FFL) is currently the gold standard for assessment of true vocal cord (TVC) mobility but is invasive and not without risk. The aim of this study was to determine the accuracy of an application-based translaryngeal ultrasonography (TLUS) as a screening tool for mobility of TVCs and to assess the feasibility of its use by an otolaryngologist not formally trained in ultrasonography. Methods: Forty children were recruited at the ear, nose and throat (ENT) clinic at Red Cross War Memorial Children’s Hospital (RCWMCH). The first author (DR), an ENT trainee, was trained by a consultant radiologist (MJ) on the use of an ultrasound probe to assess TVC mobility. Two qualified ENT specialists (neither trained in ultrasonography) consented to evaluate TLUS and FFL videos for TVC mobility. Results: In total, 135 videos were obtained from 40 participants. Ages ranged from 10 days to 9 years, and the genders were equally represented. The overall accuracy of TLUS evaluation was 95.5% (sensitivity of 100%, specificity of 60%). The reliability of TLUS when compared to FFL showed a p  0.001 and a 100% agreement between ENT specialists evaluating the shared videos. Conclusion: Our study shows TLUS to be a reliable method of assessing TVC mobility. Contribution: Translaryngeal ultrasonography is portable, noninvasive and easy to use, making it a potentially useful screening tool for practitioners other than radiologists, for example, otolaryngologists, who have a good understanding of laryngeal anatomy, especially in resource-limited settings, where FFL might not be readily available.
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spelling doaj-art-10a4eaeff7ac44668e885473f33c72052025-08-20T02:02:15ZengAOSISJournal of the Colleges of Medicine of South Africa2960-110X2024-03-0121e1e610.4102/jcmsa.v2i1.5912Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologistsDivya P. Ramyead0Fiona Kabagenyi1Sandhia Padayachee2Marc Jordaan3Shazia Peer4Division of ENT Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town Division of ENT Surgery, Red Cross War Memorial Children’s Hospital, Cape TownDepartment of ENT, Faculty of Health Sciences, Makerere University, KampalaDepartment of Paediatric Intensive Care (PICU), Faculty of Health Sciences, Sydney Children’s Hospital, Randwick, SydneyDepartment of Radiology, Morton and Partners Radiology, Cape TownDivision of ENT Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town Division of ENT Surgery, Red Cross War Memorial Children’s Hospital, Cape TownBackground: Flexible fibreoptic laryngoscopy (FFL) is currently the gold standard for assessment of true vocal cord (TVC) mobility but is invasive and not without risk. The aim of this study was to determine the accuracy of an application-based translaryngeal ultrasonography (TLUS) as a screening tool for mobility of TVCs and to assess the feasibility of its use by an otolaryngologist not formally trained in ultrasonography. Methods: Forty children were recruited at the ear, nose and throat (ENT) clinic at Red Cross War Memorial Children’s Hospital (RCWMCH). The first author (DR), an ENT trainee, was trained by a consultant radiologist (MJ) on the use of an ultrasound probe to assess TVC mobility. Two qualified ENT specialists (neither trained in ultrasonography) consented to evaluate TLUS and FFL videos for TVC mobility. Results: In total, 135 videos were obtained from 40 participants. Ages ranged from 10 days to 9 years, and the genders were equally represented. The overall accuracy of TLUS evaluation was 95.5% (sensitivity of 100%, specificity of 60%). The reliability of TLUS when compared to FFL showed a p  0.001 and a 100% agreement between ENT specialists evaluating the shared videos. Conclusion: Our study shows TLUS to be a reliable method of assessing TVC mobility. Contribution: Translaryngeal ultrasonography is portable, noninvasive and easy to use, making it a potentially useful screening tool for practitioners other than radiologists, for example, otolaryngologists, who have a good understanding of laryngeal anatomy, especially in resource-limited settings, where FFL might not be readily available.https://jcmsa.org.za/index.php/jcmsa/article/view/59translaryngeal ultrasoundflexible fibreoptic laryngoscopynonaerosol-generating procedurenoninvasivevocal cord mobilitypaediatric airway
spellingShingle Divya P. Ramyead
Fiona Kabagenyi
Sandhia Padayachee
Marc Jordaan
Shazia Peer
Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists
Journal of the Colleges of Medicine of South Africa
translaryngeal ultrasound
flexible fibreoptic laryngoscopy
nonaerosol-generating procedure
noninvasive
vocal cord mobility
paediatric airway
title Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists
title_full Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists
title_fullStr Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists
title_full_unstemmed Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists
title_short Pediatric vocal cord mobility: Translaryngeal ultrasound application for resource-limited laryngologists
title_sort pediatric vocal cord mobility translaryngeal ultrasound application for resource limited laryngologists
topic translaryngeal ultrasound
flexible fibreoptic laryngoscopy
nonaerosol-generating procedure
noninvasive
vocal cord mobility
paediatric airway
url https://jcmsa.org.za/index.php/jcmsa/article/view/59
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AT fionakabagenyi pediatricvocalcordmobilitytranslaryngealultrasoundapplicationforresourcelimitedlaryngologists
AT sandhiapadayachee pediatricvocalcordmobilitytranslaryngealultrasoundapplicationforresourcelimitedlaryngologists
AT marcjordaan pediatricvocalcordmobilitytranslaryngealultrasoundapplicationforresourcelimitedlaryngologists
AT shaziapeer pediatricvocalcordmobilitytranslaryngealultrasoundapplicationforresourcelimitedlaryngologists