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I do use vocal fremitus and it works very nicely most of the time. I had to omit this component from the presentation due to time constraints, however it is included on the extended version I will upload onto the birdultrasound.com.au website.
I think of vocal fremitus a little like I think of elastography at this stage. If a lesion is indeterminate on b-mode and Doppler assessment it will be followed up with a biopsy or at least a short time frame imaging review. The elastography and vocal fremitus characteristics will not change that management pathway at this stage.
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