Role of Laryngeal Ultrasonography in screening for laryngeal diseases in symptomatic patients

Abstract

Background: Laryngoscopy is widely considered the most appropriate tool for laryngeal imaging and diagnosis, with the disadvantage of being invasive. Computed tomography causes radiation exposure while magnetic resonance imaging is expensive, not widely available. Laryngeal ultrasound is noninvasive, safe, cheap, widely available and dynamic. Consequently it can play an important role in laryngeal imaging as demonstrated by various studies; however, there is still limited clinical application, due in part to the lack of consensus in the role of ultrasonography in laryngeal diseases

Objective: to assess the sensitivity of laryngeal ultrasound compared to indirect laryngoscopy as a screening modality for detecting laryngeal diseases in symptomatic patients.

Patients and methods: 30 undiagnosed symptomatic patients underwent laryngeal ultrasound and indirect laryngoscopy. Their results were compared.

Results: Technical success rate of laryngeal ultrasound was (25/30, 83%), and failed in 5 patients due to complete thyroid cartilage calcification. It showed overall sensitivity of (78.9%) in detecting organic laryngeal diseases with statistically significant correlation between the results of ultrasound and indirect laryngoscopy. It had high sensitivity in detecting laryngeal masses, reinke’s edema, VC cysts and polyps (100%), VC palsy (83.3%), intermediate sensitivity for VC nodules (66.7%), and poor sensitivity for laryngitis and non organic voice disorders (0%).

Conclusion: Laryngeal ultrasound is a useful non invasive imaging tool that can be used with acceptable sensitivity in screening for organic laryngeal diseases excluding laryngitis, hindered mainly by complete thyroid cartilage calcification in older males. Consequently we recommend its use as complementary to clinical examination and mirror laryngoscopy, or as an alternative to indirect laryngoscopy when required and in neck ultrasound exams when appropriate. Knowledge of its limitations, varied sensitivity in different diseases and operator dependant aspect is of utmost importance.

Key words: Laryngeal ultrasound, TCLUS, laryngoscopy, laryngeal diseases. Corresponding author: Ramy Osama Mohamed ElRayes Contact number: +20106 290 9020 Email address: ramylrayes@gmail.com