Is testing the voice under sedation reliable in medialization thyroplasty?

Abstract

Sedation exerts an important influence on voice quality. General anesthesia could be an alternative, focusing our attention on monitoring the glottis with a fibrolaryngoscope during the surgical procedure. No sedation at all can also be an alternative.

Cervical plexus block as an alternative anesthetic approach for type I thyroplasty: a case report

“… 12 Their patient was, however, sedated with intravenous (IV) midazolam (2 mg), IV fentanyl (25 µg) and a propofol infusion (70 µg·kg -1 min -1 ). As mentioned before, such sedation could affect intraoperative phonation 2 and cause airway obstruction. In the present case, combining intermediate and superficial CPB offered optimal patient comfort and excellent surgical conditions from the skin incision to the skeletonization of the thyroid cartilage.…”

“…Sedation also decreases voice testing reliability during TIP, which might explain some thyroplasty failures due to choosing an incorrect implant size. 2 …”

“…Moreover, sedation exerts an important influence on voice quality and was reported to significantly reduce voice testing reliability during TIP. 2 Therefore, it would be interesting to maximize the efficacy of local anesthesia while reducing sedation periods during TIP.…”

Medialization thyroplasty under intubation anesthesia to restore the voice after cordectomy

“…We have studied voice changes associated with sedation. 2 In our experience, voice testing during surgical procedures performed under local anesthesia is not an accurate means by which to choose the size of the prosthesis, because both sedation and pressure exerted on the larynx by the metering device can influence phonation. Therefore, we prefer to use general anesthesia when monitoring glottal changes during surgical procedures.…”

“…Sedation is required, especially if a fibrolaryngoscope is used to monitor glottal changes. We have studied voice changes associated with sedation . In our experience, voice testing during surgical procedures performed under local anesthesia is not an accurate means by which to choose the size of the prosthesis, because both sedation and pressure exerted on the larynx by the metering device can influence phonation.…”