{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T14:36:35Z","timestamp":1777991795174,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,8,5]],"date-time":"2018-08-05T00:00:00Z","timestamp":1533427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2019,2]]},"abstract":"Background<\/jats:title>Transcutaneous laryngeal ultrasound (TCLUS<\/jats:styled-content>) can assess Vocal folds (VF<\/jats:styled-content>) by subjectively identifying mobility or objectively by calculating vocal fold displacement velocity (VFDV<\/jats:styled-content>). Optimal diagnostic approach (subjective assessment, VFDV<\/jats:styled-content> estimation or a combination of both) is unresolved; hence, we conducted this prospective study in patients undergoing thyroidectomy.<\/jats:p><\/jats:sec>Method<\/jats:title>Two anaesthetists performed TCLUS<\/jats:styled-content> pre\u2010 and post\u2010operatively for functional assessment of 200 VF<\/jats:styled-content>s on 100 patients. Their findings were compared with pre\u2010operative flexible laryngoscope (FL<\/jats:styled-content>) performed by surgeons and with post\u2010operative C\u2010Mac video laryngoscope (C\u2010Mac VL<\/jats:styled-content>) by another independent anaesthetist. Correlation between FL<\/jats:styled-content> and TCLUS<\/jats:styled-content> findings and inter\u2010rater agreement between TCLUS<\/jats:styled-content> findings of both anaesthetists was analysed. Decision curve analysis (DCA<\/jats:styled-content>) was performed to compare clinical benefit of hoarseness, subjective VF<\/jats:styled-content> movement, VFDV<\/jats:styled-content>, and combined assessment for detecting disabled VF<\/jats:styled-content>s.<\/jats:p><\/jats:sec>Results<\/jats:title>We found good correlation between VF<\/jats:styled-content> mobility on TCLUS<\/jats:styled-content> and FL<\/jats:styled-content> (Spearman's r<\/jats:italic> = 0.93, P<\/jats:italic> < 0.0001) as well as C\u2010Mac VL<\/jats:styled-content> (Spearman's r<\/jats:italic> = 0.83, P<\/jats:italic> < 0.0001) with excellent inter\u2010rater agreement between both anaesthetists. DCA<\/jats:styled-content> showed combined assessment to have marginally higher clinical benefit than other diagnostic approaches at intermediate threshold probabilities while its benefit was similar to subjective evaluation at higher threshold probabilities.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Provided achievement of optimal acoustic window, TCLUS<\/jats:styled-content> can reliably assess disabled VF<\/jats:styled-content>s with FL<\/jats:styled-content> reserved for their confirmation or doubtful cases. Subjective assessment of VF<\/jats:styled-content> mobility should suffice in most cases with additional VFDV<\/jats:styled-content> estimation reserved pre\u2010operatively for situations with higher risk of VF<\/jats:styled-content>s disability, and post\u2010operatively when subjective VF<\/jats:styled-content> assessment findings are discordant from pre\u2010operative status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13234","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T07:32:44Z","timestamp":1533627164000},"page":"178-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy"],"prefix":"10.1111","volume":"63","author":[{"given":"Mamta","family":"Dubey","sequence":"first","affiliation":[{"name":"Rajiv Gandhi Cancer Institute and Research Centre New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7924-0837","authenticated-orcid":false,"given":"Amit K","family":"Mittal","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Cancer Institute and Research Centre New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiten","family":"Jaipuria","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Cancer Institute and Research Centre New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Arora","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Cancer Institute and Research Centre New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay K.","family":"Dewan","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Cancer Institute and Research Centre New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akhilesh","family":"Pahade","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Cancer Institute and Research Centre New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941212101102"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.04.063"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3393-x"},{"issue":"1","key":"e_1_2_8_5_1","first-page":"26","article-title":"Indication and validity of ultrasonographic evaluation for assessment of vocal fold mobility before and after thyroid surgery","volume":"3","author":"Ebina A","year":"2016","journal-title":"Int J Diagn Imaging"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-012-1674-1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-010-0694-2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2010.05441.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-1433.2001.02257.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.2795"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1987.6.5.225"},{"key":"e_1_2_8_12_1","first-page":"113","article-title":"Surgeon\u2010performed laryngeal ultrasound can be used to screen for vocal\u2010cord palsy before thyroid surgery","volume":"25","author":"Sturgeon C","year":"2013","journal-title":"Clin Thyroidol"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2011.09.020"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.08.071"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-016-0174-z"},{"key":"e_1_2_8_16_1","first-page":"64","article-title":"High resolution laryngeal ultrasound for diagnosis of vocal cord lesions","volume":"11","author":"Khalil T","year":"2010","journal-title":"Egypt J Ear Nose Throat Allied Sci"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(01)00399-4"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(01)00453-7"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4151-z"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.1985.12005669"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_2_8_22_1","unstructured":"VickersAJ.Decision curve analysis webpage. 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