Anesthetic Techniques for Type-1 (Medialization) Thyroplasty: A Scoping Review

Area of Science:

• Otolaryngology
• Anesthesiology
• Surgical Outcomes Research

Background:

• Medialization thyroplasty is a surgical procedure to improve voice quality in patients with vocal fold paralysis.
• Anesthesia techniques can significantly impact patient safety, experience, and surgical outcomes.

Purpose of the Study:

• To review and analyze different anesthesia techniques used for medialization thyroplasty.
• To evaluate the influence of these techniques on patient safety, experience, and surgical outcomes.

Main Methods:

• A systematic literature search was conducted across EMBASE, MEDLINE, and Web of Science.
• 28 English-language studies involving adult patients undergoing medialization thyroplasty were included.
• Outcomes analyzed included voice, complications, swallowing, operating time, length of stay, and patient-reported outcome measures (PROMs).

Main Results:

• Combined procedural sedation and local anesthesia was most common (46%), followed by local anesthesia alone (29%) and general anesthesia (25%).
• Intraoperative and postoperative complications were reported in 21% and 29% of studies, respectively.
• Voice outcomes were assessed in 50% of studies, while PROMs and swallowing outcomes were less frequently evaluated.

Conclusions:

• Medialization thyroplasty can be safely performed under various anesthesia techniques, including local anesthesia with or without sedation, and general anesthesia.
• Minimal perioperative complications were observed across techniques.
• Standardized outcome measures are needed for future research due to limited comparative data.