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Published on: April 7, 2023
Does Transcutaneous Laryngeal Ultrasonography Improve Patient-Reported Outcome Measures (PROMs) Compared to Flexible
Agastya Patel1, Piotr Spychalski2, Mohammed Albrahim2
1Department of Surgical Oncology, Transplant Surgery and General Surgery, Medical University of Gdansk, Gdansk, Poland; Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Background:
Vocal fold palsy (VFP) is a serious complication following thyroid surgery. Laryngoscopy remains the gold standard for assessing vocal fold (VF) function; however, transcutaneous laryngeal ultrasonography (TLUSG) has emerged as a non-invasive alternative with promising diagnostic performance. Despite extensive literature on TLUSG's accuracy, its impact on patient experience and acceptability remains underexplored. This study aims to evaluate and compare patient-reported outcome measures for TLUSG and laryngoscopy in peri-thyroidectomy VF assessment.
Methods And Materials:
We conducted a prospective cross-sectional survey as part of a larger TLUSG learning curve study at the Medical University of Gdansk. Patients undergoing elective thyroidectomy (n = 96) completed a validated 12-question survey immediately after undergoing both TLUSG and laryngoscopy. A purpose-designed questionnaire, with face and content validation, was used to assess physical, psychological, and procedural burdens, along with overall testing acceptability. Statistical analysis was performed using the Wilcoxon matched-pairs signed-rank and Fisher's Exact tests. Subgroup analyses explored gender, operative period, and VFP status.
Results:
A total of 116 patient responses were analyzed. TLUSG was associated with significantly lower composite burden scores than laryngoscopy (median 7 vs. 20.5, P < 0.001) and was preferred by 84.4% of patients. TLUSG showed superiority across all domains, notably in physical discomfort and invasiveness. While both tests were perceived as diagnostically effective (95.8% for TLUSG vs. 90.6% for laryngoscopy), all patients were willing to repeat TLUSG compared to 82.3% for laryngoscopy (P < 0.001). Subgroup analysis indicated reduced TLUSG comfort in males and patients with VFP.
Conclusion:
TLUSG significantly improves patient experience compared to laryngoscopy for VF assessment, offering a less invasive, more acceptable alternative. These findings support the integration of TLUSG into perioperative VF screening protocols, especially in patient-centered care frameworks. Further studies are warranted to assess its impact in routine clinical practice.
