%0 Journal Article
%T Intraoperative Ultrasonographic Assessment of Vocal Cord motion under sedation, following paediatric thyroidectomy in the Era of COVID-19: A double-blinded preliminary study.
%A Zavdy O
%A Schwarz M
%A Gilony D
%A Bachar G
%A Gilat H
%A Hod R
%J Clin Otolaryngol
%V 46
%N 6
%D 11 2021
%M 34255927
%F 2.729
%R 10.1111/coa.13835
%X Unilateral vocal cord paralysis (UVCP) is a known complication of thyroid surgery, due to iatrogenic recurrent laryngeal nerve injury, with reported rates of 2%-5% in children. The gold standard for assessing vocal cord function in flexible nasendoscopy (FNE) examination, which is considered high-risk for contraction of the COVID-19 virus. Intraoperative ultrasonographic assessment (IUA) of vocal cord function is a non-invasive and relatively simple procedure performed in a supine position, performed during spontaneous breathing, following reversed anaesthesia, while the patient is still sedated.<BR>To evaluate the validity of IUA modality in children undergoing thyroidectomy and to compare it to the standard FNE.<BR>A prospective double-blind study covering 24 months (March 2019-March 2021). Twenty thyroid lobectomies were performed, during 15 surgeries. Vocal cord function was assessed three times: Pre-operatively by FNE, intraoperative (IUA) following extubation, and a second FNE on the first post-operative day.<BR>A tertiary paediatric hospital.<BR>The overall accuracy of IUA results in our study was 92%. IUA sensitivity, specificity, positive and negative predictive values were 100%, 89%, 33% and 100%, respectively. Patient's age demonstrated borderline significance (p = .08). The resident's experience was associated with a better correlation between IUA and FNE results (p < .05).<BR>IUA of vocal cord motion has a high accuracy rate for detection of iatrogenic vocal cord paralysis, similar to FNE. It is easily learned by residents, well-tolerated by children, and it provides a safe and valid alternative modality while ensuring the safety of the medical staff in treating patients, especially in times of COVID-19 pandemic.