Objective To evaluate the vocal cord movement after stroke with laryngeal ultrasound. Methods From January, 2017 to March, 2019, 41 patients with stroke following hoarseness were examined with laryngeal ultrasound and direct laryngoscope. The movement was graded from I to III, in which grades II and III were considered as vocal cord paresis or palsy. The results under ultrasound were compared to laryngoscope (gold standard). Results For 82 sides vocal cords in 41 patients, 78 sides were consistent grading between laryngeal ultrasound and laryngoscopy, and the coincidence rate was 95.1%. The difference was mainly found in patients with bilateral vocal cord paralysis, two cases in total. Under ultrasound, one case was graded III (right) and I (left), and the other was graded II (right) and III (left); while under laryngoscopy, they were graded as III (right) and II (left), and III (right) and II (left), respectively. The specificity of ultrasound was 97.1%, and sensitivity was 85.7%, respectively.Kappa = 0.911, P < 0.001. Conclusion Laryngeal ultrasound can be used for the diagnosis and evaluation of vocal cord movement after stroke.
WU Jing-fang, LI Xue-mei, YUAN Yong-xue
. Evaluation of Vocal Cord Paralysis after Stroke with Laryngeal Ultrasound[J]. Chinese Journal of Rehabilitation Theory and Practice, 2019
, 25(7)
: 766
-770
.
DOI: 10.3969/j.issn.1006-9771.2019.07.004
1 周智永,庞康,邓斌. 143例声带麻痹患者病因分析[J]. 河北联合大学学报(医学版), 2012, 14(3): 364-365.
2 XiaC X, ZhuQ, ZhaoH X, et al. Usefulness of ultrasonography in assessment of laryngeal carcinoma [J]. Br J Radio, 2013, 86(1030): 343-348.
3 GargR, GuptaA. Ultrasound: a promising tool for contemporary airway management [J]. J Ultrason, 2015, 3(11): 926-929.
4 DedecjusM, AdamczewskiZ, BrzezińskiJ, et al. Real-time, high-resolution ultrasonography of the vocal folds-a prospective pilot study in patients before and after thyroidectomy [J]. Langenbecks Arch Surg, 2010, 395(7): 859-864.
5 武静芳,李雪梅,郭忆. 高频超声对成人喉部结构显示情况的研究[J]. 中国眼耳鼻喉科杂志, 2017, 17(6): 409-412.
6 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018 [J]. 中华神经科杂志, 2018, 5l(9): 666-682.
7 WongK P, LangB H, NgS H, et al. A prospective, assessor-blind evaluation of surgeon-performed transcutaneous laryngeal ultrasonography in vocal cord examination before and after thyroidectomy [J]. Surgery, 2013, 154(6): 1158-1165.
8 甘勇,杨婷婷,刘建新,等. 国内外脑卒中流行趋势及影响因素研究进展[J]. 中国预防医学杂志, 2019, 20(2): 139-144.
9 王陇德,王金环,彭斌,等. 《中国脑卒中防治报告2017》概要[J]. 中国脑血管病杂志, 2018, 15(11): 611-617.
10 MannG, HankeyG J, CameronD. Swallowing disorders following acute stroke: prevalence and diagnostic accuracy [J]. Cerebrovasc Dis, 2000, 10(5): 380-386.
11 司世雷. 电子X线透视吞咽功能检查在声带麻痹患者吞咽困难中应用评估及康复建议[J]. 实用医学影像杂志, 2017, 18(2): 146-148.
12 赵宁军,孙臻锋,祝江才. 甲状腺手术前后声带检查的临床意义[J]. 听力学级言语疾病杂志, 2005, 13(3): 191-192.
13 SidhuS, StantonR, ShahidiS, et al. Initial experience of vocal cord evaluation using grey-scale, real-time, B-mode ultrasound [J]. Anz J Surg, 2002, 71(12): 737-739.
14 覃折波,何芸,冯玉洁,等. 正常成人声带区解剖结构的超声成像[J]. 临床超声医学杂志, 2017, 19(1): 14-17.
15 WongK P, WooJ W, YounY K, et al. The importance of sonographic landmarks by transcutaneous laryngeal ultrasonography in post-thyroidectomy vocal cord assessment [J]. Surgery, 2014, 156(6): 1590-1596.
16 WooJ W, ParkI, ChoeJ H, et al. Comparison of ultrasound frequency in laryngeal ultrasound for vocal cord evaluation [J]. Surgery, 2017, 161(4): 1108-1112.
17 WongK P, LangB H, NgS H, et al. Is vocal cord asymmetry seen on transcutaneous laryngeal ultrasonography a significant predictor of voice quality changes after thyroidectomy? [J]. World J Surg, 2014, 38(3): 607-613.
18 李世文,华兴. 超声评价甲状腺癌术前声带麻痹的研究[J]. 临床超声医学杂志, 2018, 20(5): 340-342.
19 张冉,陈亚平,徐文. 声带麻痹合并后组颅神经损伤患者的发音和吞咽障碍康复治疗[J]. 听力学及言语疾病杂志, 2019. http://kns.cnki.net/kcms/detail/42.1391.R.20190409.1437.022.html.
20 陈晓枫,程熙,陈星,等. 间歇口腔胃管营养法配合康复治疗脑梗死恢复期真性延髓麻痹吞咽障碍[J]. 按摩与康复医学, 2018, 9(23): 1-3.