Vocal Fold Paralysis After Anterior Cervical Diskectomy and Fusion

Morpeth, James F.; Williams, Mark

doi:10.1097/00005537-200001000-00009

Cited by 113 publications

(71 citation statements)

References 16 publications

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“…However, there are studies supporting the theory that soft tissue swelling is not related to the development of postoperative dysphagia (46,48). Various causes have been implicated in the development of postoperative dysphagia, including RLN palsy, pharyngeal plexus denervation, esophageal direct injury, and regional esophageal ischemia (71)(72)(73)(74)(75). In addition, postoperative hematoma and scar tissue formation should be ruled out, especially in cases of chronic dysphagia (76).…”

Section: Dysphagiamentioning

confidence: 99%

Anterior cervical spine surgery-associated complications in a retrospective case-control study

Τάσιου¹,

Giannis²,

Brotis³

et al. 2017

J. Spine Surg.

120

113

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Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration.The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded.The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF).Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

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Section: Dysphagiamentioning

confidence: 99%

Anterior cervical spine surgery-associated complications in a retrospective case-control study

Τάσιου¹,

Giannis²,

Brotis³

et al. 2017

J. Spine Surg.

120

113

View full text Add to dashboard Cite

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“…One study identified vocal fold paralysis in 5% of patients after cervical discectomy as a reason for dysphagia including aspiration. 22 In a study using VFSS in patients suffering from CSCI to confirm dysphagia, three predictors were suggested: age, tracheotomy and mechanical ventilation and anterior approach spinal surgery. Dysphagia was found to be present in a significant percentage of those patients.…”

Section: Dysphagia In Cscimentioning

confidence: 99%

Dysphagia in patients with acute cervical spinal cord injury

Wolf

Meiners

2003

Spinal Cord

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Study design: Longitudinal observational. Objectives: (a) To establish a reliable and feasible method to indicate the presence and severity of dysphagia and (b) to establish a course of treatment in individuals presenting with cervical spinal cord injury (CSCI). Setting: Spinal Cord Injury Center, Werner Wicker Klinik, Bad Wildungen, Germany. Patients and methods: This is a cross-sectional study of 51 patients consecutively admitted to the Intensive Care Unit of the SCI in-patient service. They were subjected to neurological and fiberoptic endoscopic examination of swallowing (FEES). Data concerning artificial respiration, presence of tracheostomy, oral or non-oral feeding were obtained from the medical charts. Statistics were carried out by a calculation of a nonparametric correlation (Spearman). Results: Five levels of dysphagia could be distinguished. At levels 1 and 2, patients presented with a severe impairment of swallowing, in level 3 aspiration was met by a powerful coughing reflex, level 4 comprised a laryngeal edema and/or a mild aspiration of fluids only and at level 5 laryngeal function was not compromised. On admission, 20 patients with CSCI presented with mild (level 4), eight with moderate (level 3) and 13 with severe dysphagia (levels 1 and 2). In 10 no signs of dysphagia could be detected. After treatment, level 1 was no longer detected, one patient showed level 2, two patients showed level 3, all other patients showed only mild or no signs of dysphagia any longer. Conclusions: Dysphagia of various severities was present in the majority of these patients with CSCI together with respiratory insufficiency. FEES allows for the detection and classification of dysphagia as well as for an evaluation of the therapeutic management. Under interdisciplinary treatment the prognosis of dysphagia is good.

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“…Fountas et al [7] found in their study that Symptomatic recurrent laryngeal nerve palsy in 3.1% of the cases. Morepeth et al [8] reported an incidence of 5% for vocal fold paralysis resulting in dysphonia in their study. Lied et al [22] and Robinson et al [12] reported this complication in 0.2%, and 7.1% of their patients respectively.…”

Section: Dysphonia and Rln Injurymentioning

confidence: 81%