Paediatric Laryngeal Ultrasound: A Retrospective Cohort Study in Aotearoa New Zealand and an International Survey

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-09-30 DOI:10.1111/coa.14237

Silvia Giovanna Marinone Lares, Georgia Mackay, Sita Tarini Clark, Jeyasakthy Saniasiaya, Craig McCaffer

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Abstract

Objective

Vocal fold immobility (VFI) is a cause of significant morbidity and mortality in the paediatric population. Laryngoscopy is the current first-line investigation for patients with suspected VFI. Laryngeal ultrasound (LUS) has recently emerged as an alternative method of identifying VFI. Compared to laryngoscopy, LUS is less invasive, does not require anaesthesia, and can be performed by non-otolaryngologists. The objectives of this study are to evaluate LUS as a diagnostic method for the identification of VFI in a cohort of paediatric patients in Aotearoa New Zealand (NZ) and to estimate the frequency of use of LUS in the paediatric population by clinicians around the world.

Methods

A retrospective, single-centre cohort study was performed on all paediatric patients who had undergone laryngoscopy and LUS at Starship Children's Health in Auckland, NZ, between 2020 and 2023. An eight-question survey was also developed and distributed to better understand clinicians' use of LUS in their clinical practice to diagnose paediatric VFI globally.

Results

Twenty-nine paediatric patients met the inclusion criteria. LUS demonstrated good sensitivity (80.95%) for detecting VFI and increased to 93.33% for the detection of unilateral VFI. Of the 87 respondents to the survey, 41.38% utilise LUS in their clinical practice in the paediatric population. The main barriers to implementation of LUS as identified by non-users were lack of equipment, expertise, and training.

Conclusions

These findings support the use of LUS as an accurate diagnostic tool for the detection of unilateral VFI. Further studies in non-surgical populations and in patients with bilateral VFI, as well as standardised guidelines for LUS technique and reporting, are required.

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儿科喉部超声波：新西兰奥特亚罗瓦的回顾性队列研究和一项国际调查。

目的：声带不动（VFI）是导致儿科重大疾病和死亡的原因之一。喉镜检查是目前对疑似 VFI 患者进行检查的一线方法。喉超声（LUS）是最近出现的一种识别 VFI 的替代方法。与喉内镜检查相比，喉超声检查创伤更小，不需要麻醉，非耳鼻喉科医生也能操作。本研究的目的是评估 LUS 作为一种诊断方法在新西兰奥特亚罗瓦（Aotearoa New Zealand，NZ）一组儿科患者中对 VFI 的识别效果，并估计世界各地临床医生在儿科人群中使用 LUS 的频率：一项回顾性单中心队列研究针对 2020 年至 2023 年期间在新西兰奥克兰 Starship Children's Health 接受喉镜检查和 LUS 的所有儿科患者。为了更好地了解临床医生在临床实践中使用 LUS 诊断全球儿科 VFI 的情况，研究人员还编制并分发了一份包含八个问题的调查问卷：结果：29 名儿科患者符合纳入标准。LUS 检测 VFI 的灵敏度良好（80.95%），检测单侧 VFI 的灵敏度提高到 93.33%。在接受调查的 87 位受访者中，41.38% 在儿科临床实践中使用 LUS。未使用 LUS 的受访者认为，使用 LUS 的主要障碍是缺乏设备、专业知识和培训：这些研究结果支持使用 LUS 作为检测单侧 VFI 的准确诊断工具。需要对非手术人群和双侧 VFI 患者进行进一步研究，并制定 LUS 技术和报告的标准化指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.