Department of Otolaryngology - Head and Neck Surgery

  1. Baylor College of Medicine
  2. Departments
  3. Otolaryngology - Head and Neck Surgery
  4. Research
  5. Diagnosis and Management of Vocal Fold Mobility and Glottic Incompetence

Diagnosis and Management of Vocal Fold Mobility and Glottic Incompetence

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Laryngeal Ultrasound

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Dr. Julina Ongkasuwan, who has a joint appointment with Texas Children’s Hospital, is pioneering the use of laryngeal ultrasound (LUS) in both the pediatric and adult populations. With grant funding from the Thrasher Research Fund, she established the imaging criteria and demonstrated vocal fold immobility in neonates after congenital heart surgery. This promises to become a reliable diagnostic tool beyond flexible nasopharyngolaryngoscopy in high risk populations.

Receiving grant funding from the Texas Children’s Hospital Department of Surgery, Dr. Ongkasuwan is also exploring the use of LUS for the identification of vocal fold nodules. While the diagnosis is typically via laryngeal stroboscopy, LUS may be used to further characterize vocal fold lesions.

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Two ultrasound images of normal true vocal fold movement/position and impaired true vocal fold movement.
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Left-hand panel denotes an ultrasound image of normal true vocal fold movement/position. The right-hand panel denotes an ultrasound image of impaired true vocal fold movement.
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Schematic of laryngeal re-innervation depicts the utilization of the ansa cervicalis to provide neuronal motor input into the recurrent laryngeal never immediately prior to entry into the laryngeal musculature.
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Schematic of laryngeal re-innervation depicts the utilization of the ansa cervicalis to provide neuronal motor input into the recurrent laryngeal never immediately prior to entry into the laryngeal musculature.
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Investigators at Baylor College of Medicine and Texas Children’s Hospital utilize a variety of clinical tools to optimize the early diagnosis of vocal fold motion impairment and glottic incompetence in the setting of trauma, iatrogenic injury and prolonged intubation. These efforts are paralleled by active clinical research focused on the restoration of vocal fold mobility through laryngeal re-innervation techniques.

Recent Publications: 

Kobayashi K, You P, Devore D, Hollas S, Geraghty JR, Ongkasuwan J. Endoscopic posterior rotation flap for posterior glottic insufficiency. Laryngoscope. 2022 Jul;132(7):1452-1454.

Narawane A, Rappazzo C, Hawney J, Clason H, Roddy DJ, Ongkasuwan J. Vocal Fold Movement and Silent Aspiration After Congenital Heart Surgery. Laryngoscope. 2022 Mar;132(3):701-705. 

Alexander NL, Tran B, Zhu H, Ongkasuwan J. Learning to Interpret Pediatric Vocal Fold Mobility – A Laryngeal Ultrasound Training Module. Laryngoscope. 2021 Nov;131(11):2545-2549. 

Ongkasuwan J, Espinosa M, Procter T, Bassett E, Devore D, Hollas S, Schwabe A. Predictors of voice outcome in pediatric non-selective laryngeal reinnervation. Laryngoscope. 2020 Jun;130(6):1525-1531.