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Thyroplasty under total intravenous anaesthesia with intermittent positive pressure ventilation

Published online by Cambridge University Press:  01 December 2007

A. Karmarkar ,
N. A. Wisely ,
W. Wooldridge  and
P. Jones
A. Karmarkar*
Affiliation:
Hope Hospital, Anaesthetic Department, Salford, UK
N. A. Wisely
Affiliation:
University Hospital of South Manchester, Anaesthetic Department, Wythenshawe Hospital, Manchester, UK
W. Wooldridge
Affiliation:
University Hospital of South Manchester, Anaesthetic Department, Wythenshawe Hospital, Manchester, UK
P. Jones
Affiliation:
University Hospital of South Manchester, ENT Department, Wythenshawe Hospital, Manchester, UK
*
Correspondence to: Amar Karmarkar, Anaesthetic Department, Hope Hospital, Salford, M6 8HD, UK. E-mail: acarrom@yahoo.co.uk; Tel: +44 07 723 314 966; Fax: +44 0161 206 4677
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Summary

Background and objectives

Medialization thyroplasty is a surgical technique for improving voice quality, cough effort and laryngeal competence in patients with unilateral vocal fold paralysis. Precision surgery is enabled by operating under total intravenous anaesthesia with controlled ventilation and by using a laryngoscopic video-assisted technique. The anaesthetic challenge is to manage the shared airway with the surgeon, provide a stable operative field and ensure patient safety throughout the procedure. The objective of this case series was to evaluate the use of a modified general anaesthetic technique using the laryngeal mask airway, total intravenous anaesthesia with controlled ventilation.

Methods and results

In all, 29 patients underwent medialization thyroplasty using a disposable laryngeal mask airway, total intravenous anaesthesia and controlled ventilation. Standard anaesthetic monitoring including capnography was used intraoperatively. Total intravenous anaesthesia was achieved using effect site target-controlled infusions of propofol and remifentanil.

Conclusions

The technique proved safe with stable haemodynamic observations and only two minor complications. It also provided the surgeon with stable view of the vocal folds in order to perform this precision surgery under an operating microscope.

Keywords

VOCAL CORD PARALYSIS, surgical correction, thyroplastyARTIFICIAL VENTILATIONANAESTHESIA INTRAVENOUSLARYNGEAL MASK AIRWAY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 12 , December 2007 , pp. 1041 - 1044
Copyright
Copyright © European Society of Anaesthesiology 2007

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References

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