Экспресс-диагностика заболеваний гортани с помощью ультразвукового сканирования при профилактических осмотрах детей и подростков

Abstract

The purpose of our work was to the express diagnosis of laryngeal diseases by ultrasound scanning on children and adolescents during preventive examinations. Patients and methods: As part of a routine medical examination, 392 preschoolers and 622 senior pupils were examined in the children’s city polyclinic No. 3 in Irkutsk. All children underwent examination of ENT organs and ultrasound scanning (USS) of the larynx in the transverse direction on a portable Aloka SSD-500 apparatus with a 5 MHz sensor. We evaluated the echogenicity of the laryngeal lumen, the mobility of the vocal folds, and measured the vocal fold length from the anterior commissure to the echogenic arytenoid cartilages. Results: Dysphonia was detected in 35 (9%) preschoolers and 20 (3,2 %) high school students. With USS, all the subjects with dysphonia, except one, the larynx lumen remained echo negative, as in normal, and the mobility of the folds was symmetrical, which made it possible to exclude laryngeal tumors and laryngeal paresis. Later, during laryngoscopy, preschoolers with voice impairment were diagnosed with functional dysphonia in 23 cases and nodules of the vocal folds in 12 cases, in 15 high school students – a voice mutation, in 4 – hypotonic dysphonia. USS of the larynx made it possible to diagnose paralysis of the left half of the larynx in 2 twin girls of 6 years old without dysphonia, who had a history of heart surgery, and a volumetric formation of the left vocal fold (recurrent laryngeal papillomatosis) in a 15-year-old teenage girl. The length of the vocal folds in adolescents with a voice mutation was more than 2 cm, which corresponded to the size of the adult larynx. Conclusion: Dysphonia was detected in 9% of preschoolers and 3,2% of senior pupils. Ultrasound scanning can be used as a rapid diagnostic method of the larynx during preventive examinations. It allows detection of impaired mobility of the vocal folds and laryngeal tumors.