Ali Razfar, MD, and Seyed M. Sadr-Hosseini, MD, contributed equally to this work.
Head and Neck
Prevention and management of dysphonia during anterior cervical spine surgery†
Article first published online: 16 AUG 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 10, pages 2179–2183, October 2012
How to Cite
Razfar, A., Sadr-Hosseini, S. M., Rosen, C. A., Snyderman, C. H., Gooding, W., Abla, A. A. and Ferris, R. L. (2012), Prevention and management of dysphonia during anterior cervical spine surgery. The Laryngoscope, 122: 2179–2183. doi: 10.1002/lary.23284
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 20 SEP 2012
- Article first published online: 16 AUG 2012
- Manuscript Accepted: 7 FEB 2012
- Manuscript Revised: 3 FEB 2012
- Manuscript Received: 23 AUG 2011
- Anterior cervical spine surgery;
- Level of Evidence: 4
Dysphonia is a common postoperative complaint following anterior cervical spine surgery (ACSS). The purpose of this study was to analyze voice outcomes following ACSS, to identify risk factors predicting vocal cord impairment, and to develop an algorithm for postoperative management of dysphonic patients.
Retrospective cohort study.
This was a retrospective review of 815 consecutive patients undergoing ACSS from January 2000 to January 2009. All cases were performed using a team approach with a neurosurgeon and head and neck surgeon. Factors associated with voice change and vocal cord motion impairment were analyzed.
The mean age of the cohort was 53 years (range, 13–88 years), with a male-to-female ratio of 1.2. There were 32 of 815 available patients (3.9%) who developed dysphonia following ACSS. Fiberoptic laryngoscopy demonstrated that only nine (1.1%) of these patients had ipsilateral vocal fold motion impairment. Of these nine patients, only one (0.1%) was found to have permanent vocal fold paralysis at 1-year follow-up. Factors that correlated significantly with voice change included kyphosis, revision surgery, and level C6-C7 surgery. Kyphosis was the only independent factor correlating with voice change.
ACSS is a safe surgical procedure with a low incidence of postoperative dysphonia when exposure is provided by a head and neck surgeon. Team performance of ACSS appears to reduce laryngeal complications and optimize the management of temporary or permanent postoperative dysphonia.