Thyroplasty under general anesthesia using a laryngeal mask airway and fibreoptic bronchoscope

Grundler, S; Stacey, M.

doi:10.1007/bf03012945

Cited by 14 publications

(5 citation statements)

References 8 publications

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“…The drugs available for sedation are limited to midazolam[7] or short-acting drugs such as propofol and fentanyl[9] Anaesthetic problems also arise during general anaesthesia. [15] The surgeon needs to see the larynx to assess the position of the vocal cords as a substitute to phonation. Direct access to the larynx may be difficult in patients with cervical spine problems or other anatomical airway abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Continuous cervical epidural analgesia for Isshiki type - I thyroplasty

Trivedi¹

2010

Indian J Anaesth

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Thyroplasty is an operation on the upper airway to improve voice quality in patients with unilateral vocal cord paralysis. It is a difficult anaesthetic procedure that requires sharing the airway with the surgeon. We describe a good anaesthetic technique, which provides a safe airway with excellent operating conditions, using continuous cervical epidural anaesthesia and postoperative analgesia in three patients. The use of a regional anaesthetic technique provides excellent anaesthesia and analgesia while allowing the patient to phonate at the request of the surgeon intraoperatively.

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Section: Discussionmentioning

confidence: 99%

Continuous cervical epidural analgesia for Isshiki type - I thyroplasty

Trivedi¹

2010

Indian J Anaesth

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“…On the other hand, general anesthesia during thyroplasty surgery would allow us to objectively monitor medialization by video-laryngoscopy, better airway control, and greater comfort, as well as greater precision when choosing and placing the prosthesis. Nowadays, some work groups already use general anesthesia with a laryngeal mask and fiberscope [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], but our work group goes one step further and proposes neuromuscular relaxation during general anesthesia to keep the healthy cord sufficiently abduced so as not to affect the medialization of the cord that we want to medialized. Rocuronium bromide was the neuromuscular relaxant of choice.…”

Section: Discussionmentioning

confidence: 99%

“…However, this intraoperative voice test is not reliable as a predictor of final voice, based on our study of the effect of sedation on voice quality because the use of sedatives affects vocal parameters, therefore voice may not be a reliable measure in this surgery [ 7 ]. Some working groups already use general anesthesia and larynx mask that allows visualizing the endolarynx intraoperatively without impeding the medialization of the vocal cord and the rotation of the arytenoids, a situation that would occur with orotracheal intubation [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Anesthetic Technique and Functional Outcomes in Modified Montgomery Thyroplasty

Granell

Martin

Oishi

et al. 2023

JPM

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Background: Montgomery thyroplasty type I is a surgical technique indicated in vocal cord paralysis which consists of the paralyzed cord medialization, improving the voice quality. The objective of the study is to describe in detail the anesthetic method to obtain optimal post-medialization voice results. Methodology: Retrospective case series study including patients who underwent medialization thyroplasty using the modified Montgomery technique at the General University Hospital of Valencia between 2011 and 2021. The anesthetic technique consisted of general anesthesia with neuromuscular relaxation and a laryngeal mask. Pre- and post-surgical vocal functional data of maximum phonation times (MPT), G score, and Voice Handicap Index-30 (VHI-30) were evaluated. Results: All the patients presented an improvement in voice results, increasing MPT after surgery and a decrease in VHI-30 and G score postoperatively, with statistically significant differences between the pre- and post-surgical results (p-value < 0.05). There were no complications related to anesthesia or surgery. Conclusions: The use of general anesthesia with muscle relaxation in modified Montgomery thyroplasty may be a good option to consider. The use of a laryngeal mask for ventilation combined with a fiberoptic check allows direct visualization of the vocal cords intraoperatively, providing good functional voice results.

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“…The safe and effective uses of combined laryngeal mask airway (LMA) and flexible laryngoscopy or bronchoscopy during general anesthesia for otolaryngologic therapeutic interventions in adults and for a diagnostic intervention in a neonate have been described. [4][5][6] Dr Spiegel's patients typically undergo additional facial plastic surgical procedures that require general anesthesia and thus endotracheal tube placement following chondrolaryngoplasty. However, to use fiberoptic localization of the anterior commissure and marking with a needle, the patient must not have an endotracheal tube in place during the tracheal shave procedure.…”

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confidence: 99%