{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:34:48Z","timestamp":1789425288408,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: The primary objective of this study was to assess the value of translaryngeal ultrasound (TLUS) in assessing vocal fold (VF) function in patients after thyroid, parathyroid and neck lymph node surgery. Methods: A total of 219 patients that underwent 230 surgical procedures were enrolled in this prospective study. The study was conducted from October 2020 to October 2021. Patients\u2019 VFs were analysed independently with TLUS and laryngoscopy before and after the surgery. Various TLUS variables, such as vocal folds displacement velocity (VFDV), arytenoids symmetry and angle between VFs, were measured. The questionnaire evaluating discomfort caused to patients by both methods was conducted. Results: Of the 230 surgeries in this study, 85% were from oncological indications. The incidence of RLN injury was 10.4%. The accuracy of TLUS compared to laryngoscopy was 98.3%, with sensitivity 98.1%, specificity 100%, PPV 100% and NPV 83.3%. Laryngoscopy was found to cause significantly more discomfort than TLUS. VF visibility was lower in men; smokers; and patients with higher BMI (32 vs. 28 kg\/m2), multifocal cancer, higher left lobe volume and higher fT3 levels. Arytenoid symmetry VFDV was lower for \u201ce\u201d and \u201ci\u201d right side and \u201ci\u201d left side in injured\/disabled VFs\/RLN. Conclusions: TLUS can be an excellent and non-invasive method of VF evaluation in most patients. There are some technical aspects that can improve its accuracy. Sometimes, RLN injury after the surgery, especially among oncological patients, is unavoidable. Therefore, it is vital to diagnose dysphonia early with convenient methods, such as TLUS.<\/jats:p>","DOI":"10.3390\/jcm11061691","type":"journal-article","created":{"date-parts":[[2022,3,20]],"date-time":"2022-03-20T21:30:14Z","timestamp":1647811814000},"page":"1691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Application of Translaryngeal Ultrasound (TLUS) in Patients with Neck Surgery\u2014A Single-Centre, Prospective Cohort Study on Technique Evaluation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4826-5545","authenticated-orcid":false,"given":"Sylwia","family":"Wolff","sequence":"first","affiliation":[{"name":"Department of Endocrine Oncology and Nuclear Medicine, National Institute of Oncology, Roentgena 5 st., 02-781 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Ga\u0142\u0105zka","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Cancer Clinic, National Institute of Oncology Maria Sklodowska-Curie Memorial Institute, Roentgena 5 st., 02-781 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafa\u0142","family":"Borkowski","sequence":"additional","affiliation":[{"name":"Department of Endocrine Oncology and Nuclear Medicine, National Institute of Oncology, Roentgena 5 st., 02-781 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gorzelnik","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Cancer Clinic, National Institute of Oncology Maria Sklodowska-Curie Memorial Institute, Roentgena 5 st., 02-781 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3485-8219","authenticated-orcid":false,"given":"Marek","family":"Dedecjus","sequence":"additional","affiliation":[{"name":"Department of Endocrine Oncology and Nuclear Medicine, National Institute of Oncology, Roentgena 5 st., 02-781 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"key":"ref_1","first-page":"155","article-title":"Ultrasonography managed by internists: The stethoscope of 21st century?","volume":"214","author":"Beltran","year":"2014","journal-title":"Rev. Clin. Esp."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.5001\/omj.2011.09","article-title":"Recurrent laryngeal nerve injury in thyroid surgery","volume":"26","author":"Zakaria","year":"2011","journal-title":"Oman Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e6674","DOI":"10.1097\/MD.0000000000006674","article-title":"Recurrent laryngeal nerve injury after thyroid and parathyroid surgery: Incidence and postoperative evolution assessment","volume":"96","author":"Joliat","year":"2017","journal-title":"Medicine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1002\/hed.24772","article-title":"Management of unilateral recurrent laryngeal nerve injury after thyroid surgery: A review","volume":"39","author":"Lynch","year":"2017","journal-title":"Head Neck"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1111\/j.1445-2197.2010.05441.x","article-title":"Laryngoscopic techniques to assess vocal cord mobility following thyroid surgery","volume":"80","author":"Kundra","year":"2010","journal-title":"ANZ J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1002\/hed.26221","article-title":"Bronchoscopy, laryngoscopy, and esophagoscopy during the COVID-19 pandemic","volume":"42","author":"Bs","year":"2020","journal-title":"Head Neck"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00268-015-3393-x","article-title":"Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy","volume":"40","author":"Borel","year":"2016","journal-title":"World J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s00423-018-1734-6","article-title":"Transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the perioperative evaluation of the vocal cord mobility in thyroid surgery","volume":"403","author":"Knyazeva","year":"2018","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1007\/s00268-020-05946-9","article-title":"A Simple Tool to Improve Visualization of the Vocal Cords on Translaryngeal Ultrasound in Male Patients","volume":"45","author":"Knyazeva","year":"2021","journal-title":"World J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0892-1997(05)80341-8","article-title":"Laryngeal biomechanics: An overview of mucosal wave mechanics","volume":"7","author":"Berke","year":"1993","journal-title":"J. Voice"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/aas.13234","article-title":"Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy","volume":"63","author":"Dubey","year":"2019","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_12","unstructured":"Gajda, S., Galazka, A., and Dedecjus, M. (2022). Transcutaneous laryngeal ultrasonography in vocal folds assessment before and after thyroid surgery in the light of recent studies. Pol. J. Radiol., 2."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.surg.2004.07.018","article-title":"Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery","volume":"136","author":"Dralle","year":"2004","journal-title":"Surgery"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Patel, A., Spychalski, P., Aszkie\u0142owicz, A., Mikaszewski, B., and Kobiela, J. (2021). Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery\u2014A Systematic Review and Meta-Analysis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10225393"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1089\/thy.2016.0407","article-title":"Lessons Learned After 1000 Cases of Transcutaneous Laryngeal Ultrasound (TLUSG) with Laryngoscopic Validation: Is There a Role of TLUSG in Patients Indicated for Laryngoscopic Examination Before Thyroidectomy?","volume":"27","author":"Wong","year":"2017","journal-title":"Thyroid"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/j.surg.2014.08.071","article-title":"Feasibility of surgeon-performed transcutaneous vocal cord ultrasonography in identifying vocal cord mobility: A multi-institutional experience","volume":"156","author":"Miller","year":"2014","journal-title":"Surgery"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/0030-4220(90)90028-Q","article-title":"Calcified thyroid cartilage","volume":"70","author":"Salman","year":"1990","journal-title":"Oral. Surg. Oral. Med. Oral. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Iro, H., Bozzato, A., and Zenk, J. (2013). Atlas of Head and Neck Ultrasound, Thieme.","DOI":"10.1055\/b-002-91659"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.surg.2020.03.025","article-title":"A prospective study evaluating the feasibility and accuracy of very early postoperative translaryngeal ultrasonography in the assessment of vocal cord function after neck surgery","volume":"169","author":"Fung","year":"2021","journal-title":"Surgery"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1001\/jamaoto.2015.2795","article-title":"Assessment of Vocal Fold Function Using Transcutaneous Laryngeal Ultrasonography and Flexible Laryngoscopy","volume":"142","author":"Kandil","year":"2016","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1245\/s10434-014-4162-z","article-title":"Assessing the Validity of Transcutaneous Laryngeal Ultrasonography (TLUSG) After Thyroidectomy: What Factors Matter?","volume":"22","author":"Wong","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s00423-010-0694-2","article-title":"Real-time, high-resolution ultrasonography of the vocal folds\u2014A prospective pilot study in patients before and after thyroidectomy","volume":"395","author":"Dedecjus","year":"2010","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"599","DOI":"10.4103\/ija.IJA_197_18","article-title":"Assessment of functionality of vocal cords using ultrasound before and after thyroid surgery: An observational study","volume":"62","author":"Sinha","year":"2018","journal-title":"Indian J. Anaesth."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1097\/SLE.0b013e3181a4ccae","article-title":"Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: Our initial experience","volume":"19","author":"Lee","year":"2009","journal-title":"Surg. Laparosc. Endosc. Percutan. Tech."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1177\/0194599813487301","article-title":"Clinical practice guideline: Improving voice outcomes after thyroid surgery","volume":"148","author":"Chandrasekhar","year":"2013","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_26","first-page":"S1","article-title":"External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement","volume":"123","author":"Randolph","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/0194599820922984","article-title":"Laryngeal Evaluation during the COVID-19 Pandemic: Transcervical Laryngeal Ultrasonography","volume":"163","author":"Noel","year":"2020","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102772","DOI":"10.1016\/j.amjoto.2020.102772","article-title":"Transcutaneous laryngeal ultrasonography: A promising tool for otolaryngologists during COVID-19","volume":"42","author":"Sciancalepore","year":"2021","journal-title":"Am. J. Otolaryngol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/6\/1691\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:39:08Z","timestamp":1760135948000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/6\/1691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,18]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jcm11061691"],"URL":"https:\/\/doi.org\/10.3390\/jcm11061691","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,18]]}}}