A Simple Tool to Improve Visualization of the Vocal Cords on Translaryngeal Ultrasound in Male Patients

Laryngeal ultrasound has been increasingly used for the evaluation of the vocal cords mobility after thyroid and parathyroid surgery. The sensitivity and positive predictive value of the method are reported to be higher than 80%. Nevertheless, the visualization rate in male patients remains low; therefore, ultrasound is not attractive for the perioperative workup in those patients. In the present study, we evaluate the ability to improve the visualization rate for male patients by using a gel pad as an interface between the skin and the ultrasound probe.

Between December 2018 and January 2019, 92 male patients (mean age 49 years; range: 20-80 years) referred to our hospital with different thyroid pathologies received a laryngeal ultrasound without (TLUS) and subsequently with gel pad (G-TLUS). TLUS was performed by B-scan (probe 5-13 MHz, aperture 40 mm). The data were prospectively collected and statistically analyzed.

The visualization rate in the TLUS group was 35% (32 out of 92 patients). The use of the gel pad could increase the rate to 78% (p < 0.0001). For both groups, visualization rates are lower in older patients (> 50 years) compared to younger individuals (TLUS: 25% vs. 45%, p < 0.05; G-TLUS: 75% vs 82%, p = 0.45).

The gel pad significantly improves the vocal cord visualization rate in male patients and should be used routinely.