441. COMBINING LARYNGEAL ULTRASONOGRAPHY (LUSG) WITH VOICE ASSESSMENT OR INTRA-OPERATIVE NERVE MONITORING RESULTS ACCURATELY CONFIRMS NORMAL VOCAL CORD FUNCTION AFTER ESOPHAGECTOMY

Abstract Background Conventional diagnosis of vocal cord paresis (VCP) after esophagectomy relies on flexible laryngoscopy (FL), which is invasive. As most patients had normal post-operative VC function, a non-invasive alternative such as laryngeal ultrasonography (LUSG) may avoid unnecessary FL. LUSG was well-known to be accurate for post-thyroidectomy evaluation, but its accuracy following unclear. This prospective study assessed the feasibility and evaluate function day-1 esophagectomy. Methods Consecutive from tertiary teaching hospital who underwent elective were prospectively recruited. All received FL pre-operative Day-1, each performed by an independent, experienced blinded assessor. Exclusion criteria include VCP lost evaluation at any time points. The primary outcome in Day-1 post-esophagectomy. intermittent intra-operative nerve monitoring (IIONM) voice assessment (VA) surgery also analyzed. Results Twenty-six eligible analysis. median age 70 years (66–73). Majority male (84.6%) squamous cell carcinoma. (88.5%). Twenty-five (96.2%) three-phase Twenty-four (96%) anastomosis neck same stage. There three (11.5%) temporary one (3.8%) permanent unilateral VCP. Sensitivity, specificity 75.0%, 100.0% 98.1% respectively, superior IIONM alone (50%, 90.3%, 87.9%) or VA 90.9%, 84.6%). Combining with improved sensitivity negative predictive value could 77% FLs. Conclusion method early period results accurately confirms esophagectomy, can majority