Clinical Applications of Laryngeal Ultrasonography: A Review

Laryngeal ultrasonography (LUS) is a modern evolution of ultrasound technology that has advanced considerably since its clinical introduction in the 1970s, offering a noninvasive, radiation-free, and cost-effective imaging technique that is gaining renewed attention for its clinical applications in otolaryngology. Although available for decades, LUS remains underused in routine practice. This contemporary review synthesizes recent advances across five domains: tumor and lesion detection, vocal fold (VF) imaging, swallowing assessment, perioperative and emergency airway evaluation, and pediatric applications. Evidence shows that LUS achieves diagnostic accuracy comparable to computed tomography (CT), magnetic resonance imaging (MRI), and flexible laryngoscopy for many laryngeal disorders, while offering advantages in accessibility, bedside use, and patient comfort. Studies confirm its high sensitivity and specificity for VF immobility, and show that LUS can provide quantitative markers of dysphagia. In perioperative and emergency care, LUS supports airway screening, intubation confirmation, and postoperative monitoring. In children, it is especially valuable as a safe, noninvasive, and well-tolerated alternative to endoscopy for assessing VF mobility and nodules. Limitations include reduced visualization in calcified cartilage or obesity, signal attenuation with increasing depth, operator dependence, and incomplete evaluation of the oral and esophageal phases of swallowing. Despite these challenges, technological refinements and growing clinical experience continue to broaden its role. LUS is a versatile imaging tool with the potential to complement, and in selected cases replace, more invasive or resource-intensive methods in otolaryngology.