Related Experiment Video
Updated: Jun 25, 2026
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Incidence of perioperative airway complications in patients with previous medialization thyroplasty
Harrison W Lin1, Neil Bhattacharyya
1Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02115, USA. neiloy@massmed.org
Objectives/Hypothesis:
Determine the incidence and characterize perioperative airway complications in patients who have undergone medialization thyroplasty (MT) and subsequently undergo procedures requiring anesthesia.
Study Design:
Retrospective review of post-MT anesthesia encounters in a large academic hospital.
Methods:
A series of post-MT patients was reviewed, identifying anesthesia encounters undergoing endotracheal intubation (ETI) or laryngeal mask airway (LMA) placement. Details on the perioperative course of each encounter were extracted and examined for evidence of airway complications. The incidence of airway obstruction and need for airway intervention were determined and compared to those of control patients matched for type of procedure. Relationships between complications and perioperative management were analyzed.
Results:
A total of 74 anesthesia encounters were identified among 219 post-MT patients. Perioperative airway complications among post-MT patients arose in five procedures (6.8%; 95% CI: 1.0-12.4%). Stridor in the operating or recovery room was exhibited three times, with all episodes requiring nebulized racemic epinephrine and intravenous steroids for resolution of symptoms. One patient underwent an urgent tracheotomy for severe stridor leading to airway compromise in the recovery room. Immediately after induction with an LMA, one patient failed to maintain oxygen saturations above 90% and consequently required conversion to ETI. Among 79 matched controls without prior MT, no perioperative complications (0%) occurred (P = .027).
Conclusions:
The incidence of perioperative airway complications in post-MT patients is non-neglible and may be serious. Surgical, anesthesia, and recovery room staff should be made aware of the significantly increased risk of airway complications in post-MT patients.
Insights
Patients undergoing procedures after medialization thyroplasty (MT) face a significant risk of serious airway complications, including stridor and oxygen desaturation. Awareness among surgical and anesthesia teams is crucial for managing these increased risks.
Area of Science:
- Otolaryngology
- Anesthesiology
- Airway Management
Background:
- Medialization thyroplasty (MT) alters laryngeal anatomy, potentially impacting airway management during subsequent procedures.
- The incidence and nature of perioperative airway complications following MT are not well-characterized.
Purpose of the Study:
- To determine the incidence of perioperative airway complications in patients who have undergone MT.
- To characterize the types of airway complications encountered in the post-MT population.
- To compare complication rates between post-MT patients and a matched control group.
Main Methods:
- Retrospective review of anesthesia encounters in patients with prior MT at a large academic hospital.
- Identification of patients undergoing endotracheal intubation (ETI) or laryngeal mask airway (LMA) placement.
- Analysis of perioperative courses for airway complications, compared to matched controls without prior MT.
Main Results:
- 74 anesthesia encounters in 219 post-MT patients were reviewed; 6.8% experienced airway complications.
- Complications included significant stridor requiring medical intervention and one case of urgent tracheotomy.
- One patient required conversion from LMA to ETI due to hypoxemia; no complications occurred in 79 matched controls (P = .027).
Conclusions:
- The incidence of perioperative airway complications in post-MT patients is significant and potentially severe.
- Increased vigilance and awareness are necessary for surgical, anesthesia, and recovery room staff managing these patients.
- MT patients represent a higher-risk group for airway issues during anesthesia.
Related Concept Videos
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
01:28Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...