Dysphonia and dysphagia after anterior cervical decompression

Area of Science:

• Otolaryngology
• Neurosurgery
• Speech Pathology

Background:

• Anterior cervical decompression (ACD) is a surgical procedure to address cervical spine issues.
• Potential side effects on vocal function and swallowing are a concern for patients undergoing ACD.

Purpose of the Study:

• To investigate the incidence and duration of swallowing and vocal function impairments following ACD.
• To evaluate the role of laryngeal examination and electromyography (EMG) in managing these complications.

Main Methods:

• A cohort of 114 patients undergoing ACD was studied, divided into early (immediate post-op) and late (3-9 months post-op) assessment groups.
• A control group of 50 individuals without recent intubation was included for comparison.
• Videolaryngostroboscopy, clinical cranial nerve evaluation, and specialized assessments for dysphagia and dysphonia were performed.

Main Results:

• Immediate post-ACD, 60% reported dysphonia and 69% dysphagia; 12% experienced vocal fold paresis.
• These symptoms significantly decreased by 3-9 months postoperatively, with most vocal fold paresis cases resolving.
• Abnormal laryngeal EMG findings were noted in patients with persistent dysphonia, indicating potential recurrent laryngeal nerve damage.

Conclusions:

• Dysphonia, dysphagia, and vocal fold paresis are frequent but typically transient complications after ACD.
• Recurrent laryngeal nerve injury is a notable finding in persistent cases, detectable by EMG.
• Routine pre- and postoperative laryngeal examinations are advisable for ACD patients to monitor and manage these functional deficits.