Recurrent laryngeal nerve palsy after anterior cervical spine surgery: the impact of endotracheal tube cuff deflation, reinflation, and pressure adjustment.

摘要: Background Vocal fold immobility (paresis or paralysis) from recurrent laryngeal nerve injury remains an important cause of morbidity after anterior cervical spine surgery. A maneuver involving endotracheal tube (ETT) cuff manipulation has been proposed to reduce its incidence. This study is a randomized, prospective, double-blind investigation test the hypothesis that ETT reduces incidence postoperative vocal Methods One hundred patients scheduled undergo surgery were randomly assigned one two groups. After inducing general anesthesia, in intervention group had their pressures maintained at 20 mmHg less. placement self-retaining retractors, was deflated for 5 s and then reinflated. Patients control no further once inflated intubation. Cuff both groups recorded before skin incision (baseline) retractors (peak). Patients' motion evaluated by indirect laryngoscopy performed preoperatively postoperatively. The examination videotaped reviewed blinded otolaryngologist. Postoperative graded as normal, paretic, paralyzed. Results Complete data available 94 patients. paralysis 3.2% (95% confidence interval, 0.7-9.4%). decreased pressure but did not (15.4% vs. 14.5%). Conclusion Endotracheal deflation/reinflation adjustment do