Volume 131, Issue 11 pp. 2545-2549

Laryngology

Learning to Interpret Pediatric Vocal Fold Mobility: A Laryngeal Ultrasound Training Module

Nicole L. Alexander BSA,

Nicole L. Alexander BSA

orcid.org/0000-0002-0851-4044

School of Medicine, Baylor College of Medicine, Houston, Texas, U.S.A.

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Brandon Tran MD,

Brandon Tran MD

Department of Pediatric Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, U.S.A.

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Huirong Zhu PhD,

Huirong Zhu PhD

Department of Outcomes and Analytics, Texas Children's Hospital, Houston, Texas, U.S.A.

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Julina Ongkasuwan MD,

Corresponding Author

Julina Ongkasuwan MD

[email protected]

orcid.org/0000-0001-8621-5456

Department of Otolaryngology Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, U.S.A.

Send correspondence to Julina Ongkasuwan, MD, FAAP, FACS, Department of Otolaryngology Head and Neck Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street, Suite 640, Houston, TX 77030. E-mail: [email protected]

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Nicole L. Alexander BSA,

Nicole L. Alexander BSA

orcid.org/0000-0002-0851-4044

School of Medicine, Baylor College of Medicine, Houston, Texas, U.S.A.

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Brandon Tran MD,

Brandon Tran MD

Department of Pediatric Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, U.S.A.

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Huirong Zhu PhD,

Huirong Zhu PhD

Department of Outcomes and Analytics, Texas Children's Hospital, Houston, Texas, U.S.A.

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Julina Ongkasuwan MD,

Corresponding Author

Julina Ongkasuwan MD

[email protected]

orcid.org/0000-0001-8621-5456

Department of Otolaryngology Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, U.S.A.

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First published: 23 April 2021

https://doi.org/10.1002/lary.29582

Citations: 3

Editor's Note: This Manuscript was accepted for publication on April 13, 2021.

Podium presentation for the American Broncho-Esophagological Association (ABEA) at the Virtual Combined Otolaryngology Spring Meeting (COSM) on April 13, 2021.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

Vocal fold movement impairment (VFMI) in infants and children is most commonly evaluated by flexible nasolaryngoscopy (FNL). FNL in this population can be challenging due to movement, floppy supraglottic structures, or secretions. Laryngeal ultrasound (LUS) may be an alternative, less invasive means of evaluating VFMI that also decreases aerosolization during the COVID-19 pandemic. The primary objective was to examine LUS interpretation proficiency for VFMI via an educational module. A secondary outcome was to determine whether quantitative measurements increase interpretation accuracy.

Study Design

Prospective cohort trial.

Methods

Medical students, residents, fellows, faculty, and staff were recruited to complete the module, composed of a 13-minute teaching video followed by 20 cases. Participants determined both qualitatively (subjective assessment) and then quantitatively (through protractor measurements of the vocal fold to arytenoid angle) whether there was normal versus impaired vocal fold mobility.

Results

Thirty participants completed the LUS training module, and about one-third were otolaryngology residents. On average, each participant correctly identified 18 cases. The mean rank percent correct for quantitative measurements was significantly higher than that of qualitative interpretations (P < .0001). Measurements significantly caused participants to change their answer correctly compared to incorrectly (P < .0001). As the module progressed, there was no significant trend of more correct interpretations (P = .30). The sensitivity was higher for quantitative interpretations (89.0% vs. 87.3%) but specificity remained unchanged (92.6%).

Conclusion

Quantitative measurements may increase LUS interpretation accuracy. There was not a specific number of cases interpreted to achieve learning proficiency. LUS is an easily learned method to evaluate for VFMI across all training levels.

Level of Evidence

3 (local cohort study nonrandomized) Laryngoscope, 131:2545–2549, 2021

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Volume131, Issue11

November 2021

Pages 2545-2549

Learning to Interpret Pediatric Vocal Fold Mobility: A Laryngeal Ultrasound Training Module

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

REFERENCES

Citing Literature

References

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Learning to Interpret Pediatric Vocal Fold Mobility: A Laryngeal Ultrasound Training Module

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

REFERENCES

Citing Literature

References

Related

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