Comparative evaluation of ultrasound and fiberoptic laryngoscopy results in pediatric thyroid surgery

Pediatric patients with focal thyroid lesions requiring surgical treatment are at risk of possible development of vocal cord paresis due to intraoperative injury of the recurrent laryngeal nerve. To determine the functional status of the nerve preoperatively and postoperatively, the patients must undergo fiberoptic laryngoscopy. This examination method provides the most accurate results but is painful for children and requires additional medical equipment, including anesthesia equipment for patients who refuse to undergo the procedure without anesthesia. An alternative method for assessing VC mobility is ultrasound examination (US) of the larynx at rest and during breathing.
Purpose of the study: to compare the results of two methods of assessing VC mobility in children with thyroid masses – FL and laryngeal ultrasound.
Materials and methods. Forty pediatric patients with thyroid masses requiring surgical treatment were examined for the functional status of the vocal cords before and after surgical treatment. The mobility of the vocal cords was assessed one day before surgery and on the first postoperative day using FL and laryngeal ultrasound.
Conclusion. It seems feasible to use both methods in pediatric practice, depending on the age of the child and their individual psychoemotional characteristics (low pain threshold, fear of medical staff and equipment, etc.). According to the results of similar studies among adult patients, there is a statistically insignificant difference between the results of the two methods.
Keywords: recurrent laryngeal nerve, paresis and paralysis of the recurrent laryngeal nerve, intraoperative neurophysiologic monitoring, thyroid cancer
Conflicts of interest. The authors have no conflicts of interest to declare.
Financing. The paper was done without sponsorship.