Thyroplasty under total intravenous anaesthesia with intermittent positive pressure ventilation

Abstract

The technique proved safe with stable haemodynamic observations and only two minor complications. It also provided the surgeon with stable view of the vocal folds in order to perform this precision surgery under an operating microscope.

Anesthetic Technique and Functional Outcomes in Modified Montgomery Thyroplasty

“…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.…”

“…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 ].…”