Skip to main content
Top
Published in: World Journal of Surgery 7/2015

01-07-2015 | Original Scientific Report

A Prospective Randomized Controlled Trial of the Laryngeal Mask Airway Versus the Endotracheal Intubation in the Thyroid Surgery: Evaluation of Postoperative Voice, and Laryngopharyngeal Symptom

Authors: Byung-Joon Chun, Ja-Sung Bae, So-Hui Lee, Jin Joo, Eun-Sung Kim, Dong-Il Sun

Published in: World Journal of Surgery | Issue 7/2015

Login to get access

Abstract

Background

The present study was performed to determine whether thyroidectomy patients undergoing general anesthesia provided with a laryngeal mask airway (LMA) have a lower risk of voice-related complications and laryngopharyngeal symptoms than those undergoing endotracheal intubation (ETI).

Materials and methods

In a prospective, double-blinded, randomized clinical trial, we studied 64 patients undergoing elective thyroid lobectomy between July 2013 and February 2014. Acoustic analyses were performed preoperatively and at 48 h and 2 weeks postoperatively. The voice handicap index (VHI), M.D. Anderson dysphagia index (MDADI), and laryngopharyngeal symptom score (LPS) were determined preoperatively and at 24 h, 48 h, 1 week, and 2 weeks post-thyroidectomy.

Results

In acoustic analysis, jitter, shimmer and noise-to-harmonic ratio showed significantly better results in the LMA group than the ETI group 48 h after surgery, but there was no difference at 2 weeks. The incidence of postoperative lower-pitched voice in the LMA group was also significantly lower than that in the ETI group. In the LMA group, the VHI, MDADI, and LPS were better compared to those in the ETI group at 24 h postoperatively, and improved to the preoperative state within 1 week. However, those in the ETI group remained poorer than the preoperative values 1 week after surgery.

Conclusions

Use of the LMA in general anesthesia for thyroid surgery has advantages over the ETI in decreasing patients’ subjective and objective voice symptoms, reducing the duration of symptoms, and relieving the laryngopharyngeal symptoms.
Literature
1.
go back to reference Bhattacharyya N, Fried MP (2002) Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol Head Neck Surg 128:389–392PubMedCrossRef Bhattacharyya N, Fried MP (2002) Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol Head Neck Surg 128:389–392PubMedCrossRef
2.
go back to reference McIvor NP, Flint DJ, Gillibrand J et al (2000) Thyroid surgery and voice-related outcomes. Aust NZ J Surg 70:179–183CrossRef McIvor NP, Flint DJ, Gillibrand J et al (2000) Thyroid surgery and voice-related outcomes. Aust NZ J Surg 70:179–183CrossRef
3.
go back to reference Aluffi P, Policarpo M, Cherovac C et al (2001) Post-thyroidectomy superior laryngeal nerve injury. Eur Arch Otorhinolaryngol 258:451–454PubMedCrossRef Aluffi P, Policarpo M, Cherovac C et al (2001) Post-thyroidectomy superior laryngeal nerve injury. Eur Arch Otorhinolaryngol 258:451–454PubMedCrossRef
4.
go back to reference Keilmann A, Hulse M (1992) Dysphonia following strumectomy with normal respiratory movement of the vocal cords. Folia Phoniatr 44:261–268CrossRef Keilmann A, Hulse M (1992) Dysphonia following strumectomy with normal respiratory movement of the vocal cords. Folia Phoniatr 44:261–268CrossRef
5.
go back to reference Page C, Zaatar R, Biet A et al (2007) Subjective voice assessment after thyroid surgery: a prospective study of 395 patients. Indian J Med Sci 61:448–454PubMedCrossRef Page C, Zaatar R, Biet A et al (2007) Subjective voice assessment after thyroid surgery: a prospective study of 395 patients. Indian J Med Sci 61:448–454PubMedCrossRef
6.
go back to reference Debruyne F, Ostyn F, Delaere P et al (1997) Acoustic analysis of the speaking voice after thyroidectomy. J Voice 11:479–482PubMedCrossRef Debruyne F, Ostyn F, Delaere P et al (1997) Acoustic analysis of the speaking voice after thyroidectomy. J Voice 11:479–482PubMedCrossRef
7.
go back to reference Jones MW, Catling S, Evans E et al (1992) Hoarseness after tracheal intubation. Anaesthesia 47:213–216PubMedCrossRef Jones MW, Catling S, Evans E et al (1992) Hoarseness after tracheal intubation. Anaesthesia 47:213–216PubMedCrossRef
8.
go back to reference McHardy FE, Chung F (1999) Postoperative sore throat: cause, prevention and treatment. Anaesthesia 54:444–453PubMedCrossRef McHardy FE, Chung F (1999) Postoperative sore throat: cause, prevention and treatment. Anaesthesia 54:444–453PubMedCrossRef
9.
go back to reference Mencke T, Echternach M, Kleinschmidt S et al (2003) Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial. Anesthesiology 98:1049–1056PubMedCrossRef Mencke T, Echternach M, Kleinschmidt S et al (2003) Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial. Anesthesiology 98:1049–1056PubMedCrossRef
10.
go back to reference Biro P, Seifert B, Pasch T (2005) Complaints of sore throat after tracheal intubation: a prospective evaluation. Eur J Anaesthesiol 22:307–311PubMedCrossRef Biro P, Seifert B, Pasch T (2005) Complaints of sore throat after tracheal intubation: a prospective evaluation. Eur J Anaesthesiol 22:307–311PubMedCrossRef
11.
go back to reference Combes X, Schauvliege F, Peyrouset O et al (2001) Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology 95:1120–1124PubMedCrossRef Combes X, Schauvliege F, Peyrouset O et al (2001) Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology 95:1120–1124PubMedCrossRef
12.
go back to reference Radu AD, Miled F, Marret E et al (2008) Pharyngo-laryngeal discomfort after breast surgery: comparison between orotracheal intubation and laryngeal mask. Breast 17:407–411PubMedCrossRef Radu AD, Miled F, Marret E et al (2008) Pharyngo-laryngeal discomfort after breast surgery: comparison between orotracheal intubation and laryngeal mask. Breast 17:407–411PubMedCrossRef
13.
go back to reference Bennett J, Petito A, Zandsberg S (1996) Use of the laryngeal mask airway in oral and maxillofacial surgery. J Oral Maxillofac Surg 54:1346–1351PubMedCrossRef Bennett J, Petito A, Zandsberg S (1996) Use of the laryngeal mask airway in oral and maxillofacial surgery. J Oral Maxillofac Surg 54:1346–1351PubMedCrossRef
14.
go back to reference Shah EF, Allen JG, Greatorex RA (2001) Use of the laryngeal mask airway in thyroid and parathyroid surgery as an aid to the identification and preservation of the recurrent laryngeal nerves. Ann R Coll Surg Engl 83:315–318PubMedCentralPubMed Shah EF, Allen JG, Greatorex RA (2001) Use of the laryngeal mask airway in thyroid and parathyroid surgery as an aid to the identification and preservation of the recurrent laryngeal nerves. Ann R Coll Surg Engl 83:315–318PubMedCentralPubMed
15.
go back to reference Ryu JH, Yom CK, Park DJ et al (2014) Prospective randomized controlled trial on the use of flexible reinforced laryngeal mask airway (LMA) during total thyroidectomy: effects on postoperative laryngopharyngeal symptoms. World J Surg 38:378–384. doi:10.1007/s00268-013-2269-1 PubMedCrossRef Ryu JH, Yom CK, Park DJ et al (2014) Prospective randomized controlled trial on the use of flexible reinforced laryngeal mask airway (LMA) during total thyroidectomy: effects on postoperative laryngopharyngeal symptoms. World J Surg 38:378–384. doi:10.​1007/​s00268-013-2269-1 PubMedCrossRef
16.
go back to reference Park JO, Shim MR, Hwang YS et al (2012) Combination of voice therapy and antireflux therapy rapidly recovers voice-related symptoms in laryngopharyngeal reflux patients. Otolaryngol Head Neck Surg 146:92–97PubMedCrossRef Park JO, Shim MR, Hwang YS et al (2012) Combination of voice therapy and antireflux therapy rapidly recovers voice-related symptoms in laryngopharyngeal reflux patients. Otolaryngol Head Neck Surg 146:92–97PubMedCrossRef
17.
go back to reference Chen AY, Frankowski R, Bishop-Leone J et al (2001) The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg 127:870–876PubMed Chen AY, Frankowski R, Bishop-Leone J et al (2001) The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg 127:870–876PubMed
18.
19.
go back to reference Mupparapu M, Vuppalapati A (2005) Ossification of laryngeal cartilages on lateral cephalometric radiographs. Angle Orthod 75:196–201PubMed Mupparapu M, Vuppalapati A (2005) Ossification of laryngeal cartilages on lateral cephalometric radiographs. Angle Orthod 75:196–201PubMed
Metadata
Title
A Prospective Randomized Controlled Trial of the Laryngeal Mask Airway Versus the Endotracheal Intubation in the Thyroid Surgery: Evaluation of Postoperative Voice, and Laryngopharyngeal Symptom
Authors
Byung-Joon Chun
Ja-Sung Bae
So-Hui Lee
Jin Joo
Eun-Sung Kim
Dong-Il Sun
Publication date
01-07-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 7/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-2995-7

Other articles of this Issue 7/2015

World Journal of Surgery 7/2015 Go to the issue