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Synchronous video laryngoscopy and sonography of the larynx in children

  • Laryngology
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Abstract

Unlike laryngoscopy, laryngeal sonography is easily applicable, well tolerated by young children and less exhausting for the examiner. The aim of this study was to determine if sonography can adequately visualize the laryngeal structures and vocal fold movements of children. Synchronic video laryngoscopy and sonography of the larynx were performed in 35 children (aged 2–8 years) without a laryngeal disease. 10 investigators at differing stages of otolaryngological training were tasked with identifying vocal fold movement and specific anatomical structures after seeing (1) the sonography-only video and (2) the sonography video with a laryngoscopy video overlay. The percentage of correct identification of the structures and the vocal cord movement with and without additional video-overlay was compared. A sonographical view of the larynx could be found and the following anatomical structures were identified: subcutaneous fat tissue, left and right sternohyoid and thyrohyoid muscles, thyroid cartilage, left and right vocal folds, left and right paraglottic spaces, left and right side arytenoid cartilages, and rima glottides. Concerning the evaluation of the videos amongst the investigators: they identified >80 % of vocal fold movement and the targeted anatomical structures except the arytenoid cartilages (only up to 63 %), having the sonography only. In combination with the laryngoscopy video-overlay, investigator detection rates significantly improved (>90 % of vocal fold movement, p < 0.001; >90 % in most anatomical structures, (p < 0,001). Laryngeal sonography is a helpful diagnostic tool to identify laryngeal structures and the movement of the vocal folds in children.

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References

  1. Hawkins DB, Clark RW (1987) Flexible laryngoscopy in neonates, infants, and young children. Ann Otol Rhinol Laryngol 96:81–85

    Article  PubMed  CAS  Google Scholar 

  2. Gysin C (2008) Evaluation of the pediatric airway. Rev Med Suisse 4:2089–2090, 2092–2093 [Article in French]

  3. Wood RE (2008) Evaluation of the upper airway in children. Curr Opin Pediatr 20:266–271

    Article  PubMed  Google Scholar 

  4. Moumoulidis I, Gray RF, Wilson T (2005) Outpatient fibre-optic laryngoscopy for stridor in children and infants. Eur Arch Otorhinolaryngol 262:204–207

    Article  PubMed  Google Scholar 

  5. Johansson H, Norlander K, Berglund L, Janson C, Malinovschi A, Nordvall L, Nordang L, Emtner M (2015) Prevalence of exercise-induced bronchoconstriction and exercise-induced laryngeal obstruction in a general adolescent population. Thorax 70:57–63

    Article  PubMed  Google Scholar 

  6. Garel C, Contencin P, Polonovski JM, Hassan M, Narcy P (1992) Laryngeal ultrasonography in infants and children: a new way of investigating. Normal and pathological findings. Int J Pediatr Otorhinolaryngol 23:107–115

    Article  PubMed  CAS  Google Scholar 

  7. Friedman EM (1997) Role of ultrasound in the assessment of vocal cord function in infants and children. Ann Otol Rhinol Laryngol 106:199–209

    Article  PubMed  CAS  Google Scholar 

  8. Wang LM, Zhu Q, Ma T, Li JP, Hu R, Rong XY, Xu W, Wang ZC (2011) Value of ultrasonography in diagnosis of pediatric vocal fold paralysis. Int J Pediatr Otorhinolaryngol 75:1186–1190

    Article  PubMed  CAS  Google Scholar 

  9. Jadcherla SR, Gupta A, Stoner E, Coley BD, Wiet GJ, Shaker R (2006) Correlation of glottal closure using concurrent ultrasonography and nasolaryngoscopy in children: a novel approach to evaluate glottal status. Dysphagia 21:75–81

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mensch B (1964) Analyse par exploration ultrasonique du mouvement des cordes vocals isolées. C R Soc Biol 158:2295–2296

    Google Scholar 

  11. Bisetti MS, Segala F, Zappia F, Albera R, Ottaviani F, Schindler A (2009) Non-invasive assessment of benign vocal folds lesions in children by means of ultrasonography. Int J Pediatr Otorhinolaryngol 73:1160–1162

    Article  PubMed  Google Scholar 

  12. Baatenburg de Jong RJ, Rongen RJ, Laméris JS, Knegt P, Verwoerd CD (1993) Ultrasound in the diagnosis of laryngoceles. ORL J Otorhinolaryngol Relat Spec 55:290–293

    Article  PubMed  CAS  Google Scholar 

  13. Schade G, Kothe C, Leuwer R (2003) Sonography of the larynx-an alternative to laryngoscopy? Hno 51:585–590 [Article in German]

  14. Shanturov AG, Keiko MV (1991) The role of ultrasonic diagnosis in pediatric laryngology. Vestn Otorinolaringol 4:29–33

    PubMed  Google Scholar 

  15. Tamura E, Kitahara S, Kohno N (2001) Clinical assessment of intralaryngeal ultrasonography. Laryngoscope 111:1767–1770

    Article  PubMed  CAS  Google Scholar 

  16. Xia CX, Zhu Q, Zhao HX, Yan F, Li SL, Zhang SM (2013) Usefulness of ultrasonography in assessment of laryngeal carcinoma. Br J Radiol 86(1030):20130343

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wang LM, Zhu Q, Ma T, Li JP, Hu R, Rong XY, Xu W, Wang ZC (2011) Value of ultrasonography in diagnosis of pediatric vocal fold paralysis. Int J Pediatr Otorhinolaryngol 75:1186–1190

    Article  PubMed  CAS  Google Scholar 

  18. Vats A, Worley GA, de Bruyn R, Porter H, Albert DM, Bailey CM (2004) Laryngeal ultrasound to assess vocal fold paralysis in children. J Laryngol Otol 118:429–431

    Article  PubMed  CAS  Google Scholar 

  19. Dedecjus M, Adamczewski Z, Brzeziński J, Lewiński A (2010) Real-time, high-resolution ultrasonography of the vocal folds-a prospective pilot study in patients before and after thyroidectomy. Langenbecks Arch Surg 395:859–864

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We thank for statistical evaluation: Dipl.-Stat. Frederic Klein.

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Correspondence to Andreas H. Mueller.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Klinge, K., Guntinas-Lichius, O., Axtmann, K. et al. Synchronous video laryngoscopy and sonography of the larynx in children. Eur Arch Otorhinolaryngol 273, 439–445 (2016). https://doi.org/10.1007/s00405-015-3788-1

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  • DOI: https://doi.org/10.1007/s00405-015-3788-1

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