PMID- 22898808
OWN - NLM
STAT- MEDLINE
DCOM- 20121205
LR  - 20120921
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 122
IP  - 10
DP  - 2012 Oct
TI  - Prevention and management of dysphonia during anterior cervical spine surgery.
PG  - 2179-83
LID - 10.1002/lary.23284 [doi]
AB  - OBJECTIVES/HYPOTHESIS: Dysphonia is a common postoperative complaint following 
      anterior cervical spine surgery (ACSS). The purpose of this study was to analyze 
      voice outcomes following ACSS, to identify risk factors predicting vocal cord 
      impairment, and to develop an algorithm for postoperative management of dysphonic 
      patients. STUDY DESIGN: Retrospective cohort study. METHODS: This was a 
      retrospective review of 815 consecutive patients undergoing ACSS from January 
      2000 to January 2009. All cases were performed using a team approach with a 
      neurosurgeon and head and neck surgeon. Factors associated with voice change and 
      vocal cord motion impairment were analyzed. RESULTS: The mean age of the cohort 
      was 53 years (range, 13-88 years), with a male-to-female ratio of 1.2. There were 
      32 of 815 available patients (3.9%) who developed dysphonia following ACSS. 
      Fiberoptic laryngoscopy demonstrated that only nine (1.1%) of these patients had 
      ipsilateral vocal fold motion impairment. Of these nine patients, only one (0.1%) 
      was found to have permanent vocal fold paralysis at 1-year follow-up. Factors 
      that correlated significantly with voice change included kyphosis, revision 
      surgery, and level C6-C7 surgery. Kyphosis was the only independent factor 
      correlating with voice change. CONCLUSIONS: ACSS is a safe surgical procedure 
      with a low incidence of postoperative dysphonia when exposure is provided by a 
      head and neck surgeon. Team performance of ACSS appears to reduce laryngeal 
      complications and optimize the management of temporary or permanent postoperative 
      dysphonia.
CI  - Copyright (c) 2012 The American Laryngological, Rhinological, and Otological 
      Society, Inc.
FAU - Razfar, Ali
AU  - Razfar A
AD  - Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, 
      California, USA.
FAU - Sadr-Hosseini, Seyed M
AU  - Sadr-Hosseini SM
FAU - Rosen, Clark A
AU  - Rosen CA
FAU - Snyderman, Carl H
AU  - Snyderman CH
FAU - Gooding, William
AU  - Gooding W
FAU - Abla, Adnan A
AU  - Abla AA
FAU - Ferris, Robert L
AU  - Ferris RL
LA  - eng
PT  - Journal Article
DEP - 20120816
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Algorithms
MH  - Causality
MH  - Cervical Vertebrae/*surgery
MH  - Cohort Studies
MH  - Comorbidity
MH  - Dysphonia/diagnosis/epidemiology/*prevention & control
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intervertebral Disc Degeneration/surgery
MH  - Male
MH  - Middle Aged
MH  - Orthopedic Procedures/*statistics & numerical data
MH  - Postoperative Care/methods
MH  - Postoperative Complications/diagnosis/epidemiology/*prevention & control
MH  - Pseudarthrosis/surgery
MH  - Recurrent Laryngeal Nerve Injuries/epidemiology/*prevention & control
MH  - Reoperation
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sex Distribution
MH  - Spinal Diseases/*surgery
MH  - Spinal Stenosis/surgery
MH  - Spondylosis/surgery
MH  - Vocal Cord Paralysis/diagnosis/epidemiology/*prevention & control
MH  - Young Adult
EDAT- 2012/08/18 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/08/18 06:00
PHST- 2011/08/23 00:00 [received]
PHST- 2012/02/03 00:00 [revised]
PHST- 2012/02/07 00:00 [accepted]
PHST- 2012/08/18 06:00 [entrez]
PHST- 2012/08/18 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.1002/lary.23284 [doi]
PST - ppublish
SO  - Laryngoscope. 2012 Oct;122(10):2179-83. doi: 10.1002/lary.23284. Epub 2012 Aug 
      16.