Is dysphonia permanent or temporary after anterior cervical approach?

Area of Science:

• Neurosurgery
• Otolaryngology
• Spinal Surgery

Background:

• Anterior cervical approach (ACA) is a common surgical technique for cervical disc disease.
• Postoperative complications, including dysphonia, can impact patient outcomes.
• Understanding the incidence and prognosis of dysphonia after ACA is crucial for patient counseling and surgical technique refinement.

Purpose of the Study:

• To investigate the incidence, causes, and prognosis of dysphonia following anterior cervical approach (ACA).
• To evaluate the rate of recurrent laryngeal nerve (RLN) injury and its association with dysphonia.
• To determine the recovery pattern and duration of dysphonia in patients undergoing ACA.

Main Methods:

• Retrospective chart review of 235 consecutive patients who underwent ACA for cervical disc disease over a 10-year period.
• Analysis of patient records to identify cases of postoperative dysphonia and vocal cord paralysis.
• Laryngoscopic examinations were performed to confirm unilateral vocal cord paralysis in affected patients.

Main Results:

• Dysphonia occurred in 3 out of 235 patients (1.27%) following ACA.
• Recurrent laryngeal nerve (RLN) injury was identified as the cause in all affected patients.
• All patients experienced temporary unilateral vocal cord paralysis, with full recovery of voice within a mean of 2 months (range 1-3 months).

Conclusions:

• Dysphonia is a rare complication after ACA, with a low incidence of 1.27% in this series.
• Temporary RLN injury, likely due to pressure or retraction during surgery, is the primary cause of dysphonia.
• No permanent dysphonia was observed, indicating a favorable prognosis for voice recovery after ACA.