Complications after type one thyroplasty: is day-case surgery feasible?

Abstract

The only complications in this series were in patients taking anticoagulation medication, undergoing revision surgery, or in whom the laryngeal tissue was atrophic or absent. Careful patient selection to exclude any of the above should reduce the risk of complications. The authors would therefore advocate type one thyroplasty for unilateral or bilateral vocal fold paralysis as a suitable procedure for day-case surgery within our department.

Lack of Adverse Events after Medialization Laryngoplasty with the Montgomery Thyroplasty Implant in Patients with Unilateral Laryngeal Nerve Paralysis

“…No significant statistical relationship was noted between hematoma and the variables under analysis, but the incidence varied from 14.3% (3 of 21) in patients who were under antithrombotic treatment to 3.6% (6 of 163) in patients who were not (p = 0.068). In agreement with Bray et al, 16 we think that patients under anticoagulation treatment are not suitable for day-case ML. According to Tucker et al, 10 the use of a drill instead of an oscillating saw for cutting the window through the thyroid ala in patients older than 50 years of age could, by burnishing the calcified edges of the marrow, limit bleeding from this area and reduce the risk of late endolaryngeal hematoma.…”

“…On the basis of these results, together with the extremely low rate of infection at the insertion site reported over the past 15 years in patients managed with ML alone and the fact that the incidence of postoperative infection did not increase in a series 16 in which antibiotics were not routinely used after operation, it appears to us that the need for antibiotic treatment after ML is questionable.…”

Medialization laryngoplasty/arytenoid adduction: U.S. outcomes, discharge status, and utilization trends

“…Medialization laryngoplasty (ML) and arytenoid adduction (AA) are effective permanent procedures to improve dysphonia due to unilateral vocal fold paralysis . However, postoperative complications can arise, such as laryngeal edema, hematoma, and airway compromise . Several studies have evaluated complications after ML and/or AA, but all are small, single‐institution, retrospective case series that may not be generalizable to other settings or patient groups .…”

“…However, postoperative complications can arise, such as laryngeal edema, hematoma, and airway compromise . Several studies have evaluated complications after ML and/or AA, but all are small, single‐institution, retrospective case series that may not be generalizable to other settings or patient groups . Depending on patient comorbidities, physician training and experience, and other factors, surgeons may decide to discharge their patient on the same day or observe overnight or longer.…”

“…Depending on patient comorbidities, physician training and experience, and other factors, surgeons may decide to discharge their patient on the same day or observe overnight or longer. There is no clear consensus on best practice for disposition, although within the last decade outpatient ML in select patients has been described in the literature . In order to evaluate a large number of cases, a national survey on ML and AA was previously administered based on an estimate of cases and complications with the usual limitations of retrospective survey data .…”