Abstract
Objectives/Hypothesis:
Determine the incidence and characterize perioperative airway complications in patients who have undergone medialization thyroplasty (MT) and subsequently undergo procedures requiring anesthesia.
Study Design:
Retrospective review of postโMT anesthesia encounters in a large academic hospital.
Methods:
A series of postโMT patients was reviewed, identifying anesthesia encounters undergoing endotracheal intubation (ETI) or laryngeal mask airway (LMA) placement. Details on the perioperative course of each encounter were extracted and examined for evidence of airway complications. The incidence of airway obstruction and need for airway intervention were determined and compared to those of control patients matched for type of procedure. Relationships between complications and perioperative management were analyzed.
Results:
A total of 74 anesthesia encounters were identified among 219 postโMT patients. Perioperative airway complications among postโMT patients arose in five procedures (6.8%; 95% CI: 1.0โ12.4%). Stridor in the operating or recovery room was exhibited three times, with all episodes requiring nebulized racemic epinephrine and intravenous steroids for resolution of symptoms. One patient underwent an urgent tracheotomy for severe stridor leading to airway compromise in the recovery room. Immediately after induction with an LMA, one patient failed to maintain oxygen saturations above 90% and consequently required conversion to ETI. Among 79 matched controls without prior MT, no perioperative complications (0%) occurred (P = .027).
Conclusions:
The incidence of perioperative airway complications in postโMT patients is nonโneglible and may be serious. Surgical, anesthesia, and recovery room staff should be made aware of the significantly increased risk of airway complications in postโMT patients. Laryngoscope, 2009