Safety of outpatient unilateral medialization laryngoplasty across two academic institutions

Chau, Steven M.; Kim, Christine M.; Vahabzadeh‐Hagh, Andrew M.; Verma, Sunil P.; Chhetri, Dinesh K.

doi:10.1002/lary.27688

Cited by 6 publications

(14 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reported complication rate for patients undergoing type 1 thyroplasty is between 7% and 20%. 12,13,15,17,18,[19][20][21][22] However, our study found a major complication rate of 5.6% with no long-term morbidity or mortalities. There were 4 cases of airway complications that were considered major; however, none of the patients required intubation or tracheostomy.…”

Section: Discussionmentioning

confidence: 73%

“…These data fit well with other published reports. Of the 214 patients who underwent outpatient type 1 thyroplasty in studies published by Chau et al, 19 Junlapan et al, 15 Cotter et al, 13 Zhao et al, 20 and Bray et al, 18 there were no obstructive hematomas or need for intubation or surgical airway intervention in the acute postoperative period. The only complications of nonobstructive hematoma and implant extrusion occurred in patients on anticoagulation and in patients with poor implant placement or prior radiation therapy, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…17 Many studies advocate for risk stratification based on patient comorbidities to determine whether a patient may require postoperative observation to prevent major complications, specifically airway compromise. 15,[18][19][20] The 2 operating surgeons (M.B. and J.S.)…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Safety of Outpatient Type 1 Thyroplasty

et al. 2020

View full text Add to dashboard Cite

Objective: Type 1 thyroplasty is an established procedure for the treatment of vocal fold paralysis to improve voice and swallowing outcomes. At our institution, we commonly perform this procedure on an outpatient basis in medically stable patients. With this study, we assess the safety of outpatient thyroplasty by examining complication and readmission rates, need for revision surgery, and predictors of these outcome measures. Methods: We performed a retrospective review of patients undergoing outpatient type 1 thyroplasty for vocal fold paralysis between 2013 and 2018 at our institution. We documented the etiology of paralysis, comorbidities, and demographic data. Our primary outcome measures were complications, need for readmission, and need for revision surgery. Results: During the study period, 160 patients met our inclusion criteria. Mean age at time of surgery was 62.1 ± 13.9 years; there were 82 (51%) males and 78 (49%) females. Nine (5.6%) patients experienced major complications after surgery and 7 (4.4%) patients required unplanned readmission. Mean time to complication was 6.9 ± 9.7 days. There were no instances of postoperative airway compromise requiring intervention. There were no mortalities. Of those who underwent primary surgery, 22 (14%) patients required revision surgery. Conclusion: Given that complications tend to occur in a delayed fashion rather than in the acute postoperative period, same-day discharge seems reasonable as compared to overnight observation in medically stable patients undergoing type 1 thyroplasty. Level of Evidence: IV

show abstract

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety of Outpatient Type 1 Thyroplasty

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Multiple studies promote risk stratification to determine, which patients may be discharged safely, and which may be at a higher risk for complications or potential readmissions requiring overnight observation. 12,14,18,19 In our study, with a large number of patients, we observed that 4.9% of patients suffered an adverse event within 30 days following surgery, with a readmission rate of 2.1% (at days 2, 5, 7, 9, 10, and 17), a reoperation rate of 1.8% (at days 0, 0, 1, 6, and 20) and a 30-day mortality rate of 1.4%. There were two patients who underwent unplanned reintubations.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,10 The more serious complications are thought to be seen more frequently in AA. 7,11 While recent studies have demonstrated that LFS is safe to be performed as an outpatient procedure due to a low percentage of patients with immediate complications, [12][13][14] risk factors leading to admission or increased complication rates remain undetermined. Identification of these risk factors for complications may help better target postoperative observation to select patients undergoing LFS.…”

Section: Introductionmentioning

confidence: 99%

Safety and Predictors of 30‐Day Adverse Events of Laryngeal Framework Surgery: An Analysis of ACS‐NSQIP data

et al. 2021

View full text Add to dashboard Cite

Objectives/Hypothesis: To characterize and identify predictors of 30-day adverse events in patients undergoing laryngeal framework surgery (LFS).Study Design: This study is a retrospective analysis of the National Surgical Quality Improvement dataset. Methods: LFS cases were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2008 to 2018. Demographic variables, patient comorbidities, and perioperative outcomes (any adverse event, 30-day readmission, 30-day reoperation, and unplanned intubation) were extracted. Patient-specific and surgery-specific factors associated with perioperative adverse events were examined using descriptive statistics and univariate logistic regression (LR).Results: Of 283 patients who underwent LFS, 225 underwent laryngoplasty medialization, 56 underwent laryngoplasty medialization with arytenoidectomy or arytenoidopexy via an external approach, and 2 underwent local myocutaneous or fasciocutaneous advancement flap along with laryngoplasty. Medical comorbidities were present in 33.6% of patients and 57.9% were American Society of Anesthesiologists (ASA) Class III/IV (57.9%). LFS was performed as same-day surgery in 30.7% of cases. Fourteen patients (4.9%) suffered an adverse condition within 30 days following surgery. In univariate LR, ASA Class III or IV (odds ratio [OR] 4.6, 95% confidence interval [CI] 1.2-30.1) was the only predictor associated with any adverse event. Arytenoid adduction (AA) was associated with increased risk of reoperation within 30 days of the initial surgery (OR 6.4, 95% CI 1.0-49).Conclusions: LFS is a generally safe procedure with infrequent perioperative adverse events. In the ACS-NSQIP database, ASA classification of III or IV was associated with a higher risk for any 30-day adverse event and AA was associated with a higher risk for 30-day reoperation.

show abstract

Safety and Adverse Events of Medialization Thyroplasty: A Systematic Review

Valley,

Karp,

Garber

2023

The Laryngoscope

View full text Add to dashboard Cite

IntroductionUnilateral vocal fold paralysis or paresis (UVFP) is a condition that causes significant morbidity due to dysphonia, dysphagia, and aspiration. Type I medialization thyroplasty (MT) is the current mainstay surgical treatment for UVFP. Though widely considered a safe procedure, concerns exist over possible airway complications which can lead to overnight observation. Herein, we report a systematic review of the safety and adverse events of MT to aid in determining the safety of same‐day discharge.Data SourcesPubMed and Embase databases.Review MethodsOur search identified studies investigating complications associated with MT. Articles were selected if published between January 1, 1989 and March 15, 2023. Abstracts were screened, and data were extracted from included studies. Only Type I MT procedures were included; case reports were excluded. Participant characteristics, intervention details, results, and adverse events were extracted.ResultsThe database query identified 751 abstracts, of which 46 studies met eligibility criteria. A total of 2426 patients underwent MT. The most common implant was Silastic (n = 898, 37.0%) followed by Gore‐Tex (n = 664, 27.4%). There were 254 (10.5%) total complications reported; 110 (4.5%) were considered major. The most common complication was nonobstructive hematoma (n = 59, 2.4%) followed by hemorrhage (n = 36, 1.5%). Implant extrusion (n = 24, 0.99%) or displacement (n = 15, 0.62%) occurred mostly in Silastic and Gore‐Tex implants. Same‐day discharge occurred with 429 patients and was not associated with adverse events.ConclusionsUVFP can be reliably improved by MT with a low risk of complications. Outpatient MT is a promising treatment with a favorable safety profile. Laryngoscope, 2023

show abstract

Safety of outpatient unilateral medialization laryngoplasty across two academic institutions

Cited by 6 publications

References 17 publications

Safety of Outpatient Type 1 Thyroplasty

Safety of Outpatient Type 1 Thyroplasty

Safety and Predictors of 30‐Day Adverse Events of Laryngeal Framework Surgery: An Analysis of ACS‐NSQIP data

Safety and Adverse Events of Medialization Thyroplasty: A Systematic Review

Contact Info

Product

Resources

About