Postoperative laryngeal symptoms in a general surgery setting. Clinical study

Area of Science:

• Anesthesiology
• Otolaryngology
• Surgical Complications

Background:

• Post-general anesthesia complications like vocal cord injuries (VI), postoperative hoarseness (PH), dysphonia (DN), dysphagia (DG), and sore throat (ST) are common.
• Lack of consensus exists regarding optimal timing for post-operative laryngoscopy to diagnose laryngeal or vocal fold lesions.
• Limited studies address laryngeal trauma specifically from orotracheal intubation.

Purpose of the Study:

• To evaluate the statistical relationship between anatomical, anesthesiological, and surgical variables and the occurrence of PH, DG, or impaired voice register.
• To investigate the incidence and potential causes of laryngeal trauma following orotracheal intubation.

Main Methods:

• A cohort of 50 patients undergoing various surgeries were evaluated using direct laryngoscopy pre-surgery, within 6 hours, at 72 hours, and after 30 days.
• Assessment included vocal fold and arytenoid evaluation, motility, breathing space, and phonatory function.
• Statistical analysis correlated pre- and intraoperative variables with laryngeal symptoms and lesions.

Main Results:

• Vocal fold edema showed a statistically significant relation to smoking (p < 0.005).
• Self-limiting dysphagia and dysphonia were more prevalent in younger patients (p < 0.005) and after thyroidectomy (p < 0.01).
• No significant relation was found between prolonged intubation, GERD, specific maneuvers, or Mallampati/Cormack-Lehane scores and postoperative complications.

Conclusions:

• Direct laryngoscopy is crucial for detecting arytenoid lesions post-orotracheal intubation.
• Temporary postoperative dysphonia or hoarseness may result from arytenoid edema, detectable by laryngoscopy around 72 hours post-surgery.
• These findings necessitate inclusion in surgical informed consent protocols.