Interpreting Pediatric Laryngeal Ultrasonography: A Training Protocol for Novice Examiners

Abstract

Objective: Laryngeal ultrasonography (LUS) is a noninvasive alternative to nasal endoscopy for diagnosing vocal fold pathologies in the pediatric population. Inducing less discomfort and physiological impact, LUS is more well tolerated by young patients. Despite its advantages, interpreting ultrasound images is highly subjective, potentially undermining diagnostic accuracy. To address the limitation, this research aims to evaluate the effect of training on novice examiners’ LUS interpretation proficiency and, secondly, whether examiners’ interpretation confidence increases after receiving the training. Method: Thirty-eight novice examiners were randomly assigned to the experimental and control group where the former received training. A stimulus– response–feedback–stimulus paradigm was employed in the training. Qualitatively, the presence of vocal fold lesions and vocal fold motion impairment was examined. Quantitatively, the left and right vocal fold–arytenoid angles were measured. Results: Results showed that training significantly improved diagnostic accuracy in qualitative measurements. Quantitatively, statistically significant effects were found posttraining with enhanced intrarater agreement and reduced interrater variability. A substantial increase in interpretation confidence was observed following training. Conclusions: In conclusion, there is an overall significant training effect on novice examiners’ proficiency in LUS image interpretation. For future directions, it is recommended to investigate the training effect on the proficiency from ultrasound image acquisition to interpretation.