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.
Similar content being viewed by others
References
Hawkins DB, Clark RW (1987) Flexible laryngoscopy in neonates, infants, and young children. Ann Otol Rhinol Laryngol 96:81–85
Gysin C (2008) Evaluation of the pediatric airway. Rev Med Suisse 4:2089–2090, 2092–2093 [Article in French]
Wood RE (2008) Evaluation of the upper airway in children. Curr Opin Pediatr 20:266–271
Moumoulidis I, Gray RF, Wilson T (2005) Outpatient fibre-optic laryngoscopy for stridor in children and infants. Eur Arch Otorhinolaryngol 262:204–207
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
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
Friedman EM (1997) Role of ultrasound in the assessment of vocal cord function in infants and children. Ann Otol Rhinol Laryngol 106:199–209
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
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
Mensch B (1964) Analyse par exploration ultrasonique du mouvement des cordes vocals isolées. C R Soc Biol 158:2295–2296
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
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
Schade G, Kothe C, Leuwer R (2003) Sonography of the larynx-an alternative to laryngoscopy? Hno 51:585–590 [Article in German]
Shanturov AG, Keiko MV (1991) The role of ultrasonic diagnosis in pediatric laryngology. Vestn Otorinolaringol 4:29–33
Tamura E, Kitahara S, Kohno N (2001) Clinical assessment of intralaryngeal ultrasonography. Laryngoscope 111:1767–1770
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
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
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
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
Acknowledgments
We thank for statistical evaluation: Dipl.-Stat. Frederic Klein.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval
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.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-015-3788-1