Factors Influencing the Accessibility of Transcutaneous Laryngeal Ultrasound in Patients with Glottic Insufficiency Undergoing Injection Laryngoplasty

Abstract Background: Transcutaneous laryngeal ultrasound (TLUS) can provide a series of high-resolution images of the laryngeal anatomy and guide injection laryngoplasty (IL). This study aimed to assess the factors affecting the accessibility of the larynx during TLUS. Methods: Patients with glottic insufficiency undergoing IL were included. All patients underwent TLUS before IL in an office setting. Patient demographic data, including age, sex, height, weight, comorbidities, the site of IL, the reason for IL, history of neck surgery or radiotherapy, and accessibility, were recorded. Results: In all, 85 patients, including 46 women and 39 men, were enrolled. Multiple logistic regression analysis revealed age and sex as the most important factors influencing the accessibility of TLUS. Patients with inaccessibility during TLUS, defined as an inability to visualize the vocal folds using the anterior, lateral, and lateral longitudinal approaches, were significantly older (odds ratio [OR] = 1.089, 95% confidence interval [CI] = 1.005–1.179, P = 0.037) and more commonly male (OR = 75.603, 95% CI = 8.359–683.819, P < 0.001) than those in whom laryngeal access was achieved. Conclusion: TLUS is an objective assessment and real-time tool for patients undergoing IL. Female and younger patients are considered better candidates for IL under TLUS or for follow-up evaluation using TLUS.