Assessing vocal fold movement in healthy young children and infants using laryngeal ultrasound by speech and language therapists: a feasibility study.

چکیده اصلی

BACKGROUND: Vocal fold motion impairment (VFMI) is a common laryngeal disorder in infants and young children and may impact respiration, phonation and swallowing. Flexible nasendoscopy (FNE) is the current gold standard for assessment; however, its invasive nature may limit its use for routine screening. Recent studies reported good sensitivity and specificity of laryngeal ultrasound (LUS), a minimally invasive alternative compared to FNE. However, its application by Speech and Language Therapists (SLTs) in the paediatric population remains underexplored. OBJECTIVES/HYPOTHESIS: This study aimed to evaluate the feasibility of a novel SLT-led LUS protocol for infants and young children and to examine the reliability of defined laryngeal measurements. METHODS: In this mixed-methods feasibility study, eleven participants (nine children aged 3- and 4-years-old and two 2-month-old infants) underwent an SLT-led LUS protocol incorporating quiet breathing and functional tasks. Completion and visualisation rates were analysed as an indicator of feasibility. Laryngeal landmarks were identified and laryngeal measurements were quantified in selected static images by two raters. Inter- and intra-rater reliability were evaluated using intraclass correlation coefficients (ICC). Inductive thematic analysis of the LUS operator's field notes was used to identify experiences of conducting the protocol and areas for future refinement. RESULTS: The protocol demonstrated high feasibility, with good completion and visualisation rates. Differences were noted across tasks, with a higher visualisation rate in quiet breathing and swallowing than in phonation. Inductive thematic analysis of the LUS operator's experience highlighted areas for future refinement of the protocol. Quantitative analysis showed excellent reliability between raters across laryngeal measures, with moderate to excellent confidence intervals. CONCLUSION: This feasibility study provides initial evidence for an SLT-led LUS protocol to assess paediatric laryngeal function. LUS may enhance clinical pathways by enabling non-invasive screening and monitoring, while also serving as a research tool for phonation and swallowing. Further studies with larger and more diverse samples, including those with VFMI, are needed to establish clinical utility and generalisability.

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