Prevention and management of dysphonia during anterior cervical spine surgery

@article{Razfar2012PreventionAM,
  title={Prevention and management of dysphonia during anterior cervical spine surgery},
  author={Ali Razfar and Seyed M. Sadr-Hosseini and Clark A. Rosen and Carl H. Snyderman and William E. Gooding and Adnan A. Abla and Robert L Ferris},
  journal={The Laryngoscope},
  year={2012},
  volume={122}
}
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. 
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Lower cervical levels: Increased risk of early dysphonia following anterior cervical spine surgery
Recurrent Laryngeal Nerve Palsy after Anterior Cervical Discectomy and Fusion - Prevalence and Risk Factors.
TLDR
The fact that none of the examined variables was associated with the occurrence of RLNP supports the view that postoperative RLNP may depend more on direct mechanical manipulation during surgery than on specific patient or surgical characteristics.
The Presence of Thyroid Cartilage at the Surgical Level Reduces Early Dysphagia after Single-Level Anterior Cervical Surgery: A Retrospective Study
TLDR
It is found that early dysphagia, which is a self-limiting complication, was correlated with surgery performed at levels outside the thyroid cartilage region.
Oropharyngeal Dysphagia after Anterior Cervical Spine Surgery: A Review
TLDR
Large, prospective, randomized studies are required to confirm the incidence, prevalence, etiology, mechanisms, long-term natural history, and risk factors for the development of dysphagia after ACSS, as well as to identify prevention measures.
Long-term result of vocal cord paralysis after anterior cervical disectomy
TLDR
Only 0.47 % of patients underwent ACDF in this retrospective study documented prolonged postoperative VCP, while most patients recovered within 9 months, however, if symptoms last longer, there could be almost permanent VCP (0.16 %).
Dysphagia Rates after Anterior Cervical Diskectomy and Fusion: A Systematic Review and Meta-Analysis
TLDR
This review represents a comprehensive estimation of the actual incidence of dysphagia across a heterogeneous group of surgeons, patients, and criteria and recommends the use of a standardized, well-outlined method for dysphagian diagnosis.
Vocal cord palsy after anterior cervical spine surgery: a qualitative systematic review.
Intraoperative Measurement of Endotracheal Tube Cuff Pressure and Its Change During Surgery in Correlation With Recurrent Laryngeal Nerve Palsies, Hoarseness, and Dysphagia After Anterior Cervical Discectomy and Fusion: A Prospective Randomized Controlled Trial.
TLDR
Unregulated ETCP can lead to a significantly higher incidence of hoarseness; however, its improvement rate is 100%.
Comparison of Patient-Reported Postoperative Dysphagia in Patients Undergoing One-Level Versus Two-Level Anterior Cervical Discectomy and Fusion with the Zero-P Implant System
TLDR
Two-level ACDF with the Zero-P can result in a significantly greater incidence and severity of transient postoperative dysphagia, and older age, two-level surgery, greater prevertebral soft tissue swelling (PSTS) and the difference between the postoperative and preoperative C 2–7 angle were significantly associated with a higher incidence.
Risk factors and preventative measures of early and persistent dysphagia after anterior cervical spine surgery: a systematic review
TLDR
Adequate preoperative preparation of the patients including preoperative tracheal traction exercise and quitting smoking, proper preventative measures during surgery are essential for preventing early and persistent dysphagia after anterior cervical spine surgery (ACSS).
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References

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Vocal Fold Paralysis After Anterior Cervical Diskectomy and Fusion
Objective: The anterior approach to the cervical spine now serves as the surgical access of choice for cervical spine disease. Vocal fold paralysis (VFP) may follow the procedure as a complication.…
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TLDR
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TLDR
Monitoring of ET cuff pressure and release after retractor placement may prevent injury to the RLN during anterior cervical spinesurgery, and the findings confirmed that the retractor displaced the larynx against the shaft of the ET, allowing impingement on the vulnerable intralaryngeal segment of theRLN.
Oropharyngeal Dysphagia after Anterior Cervical Spine Surgery: A Review
TLDR
Large, prospective, randomized studies are required to confirm the incidence, prevalence, etiology, mechanisms, long-term natural history, and risk factors for the development of dysphagia after ACSS, as well as to identify prevention measures.
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TLDR
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Long-term result of vocal cord paralysis after anterior cervical disectomy
TLDR
Only 0.47 % of patients underwent ACDF in this retrospective study documented prolonged postoperative VCP, while most patients recovered within 9 months, however, if symptoms last longer, there could be almost permanent VCP (0.16 %).
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TLDR
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TLDR
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