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Endotracheal tube positioning during neck extension in thyroidectomy

Published online by Cambridge University Press:  07 September 2015

S D Sharma ,
G Kumar ,
H Kanona ,
T Jovaisa  and
H Kaddour
S D Sharma*
Affiliation:
Department of Otorhinolaryngology, Queens Hospital, Romford, UK
G Kumar
Affiliation:
Department of Otorhinolaryngology, Queens Hospital, Romford, UK
H Kanona
Affiliation:
Department of Otorhinolaryngology, Queens Hospital, Romford, UK
T Jovaisa
Affiliation:
Department of Otorhinolaryngology, Queens Hospital, Romford, UK
H Kaddour
Affiliation:
Department of Otorhinolaryngology, Queens Hospital, Romford, UK
*
Address for correspondence: Mr Sunil Dutt Sharma, Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford RM7 0AG, UK Fax: +44 1708 435096 E-mail: sunilsharma@doctors.org.uk
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Abstract

Objective:

To evaluate the effect of body mass index and neck length on endotracheal tube movement during neck extension in thyroidectomy.

Methods:

A prospective study was conducted of 30 patients undergoing thyroidectomy during an 8-month period. Patient characteristics were recorded and endotracheal tube displacement was determined.

Results:

Mean body mass index was 27.8 kg/m2 (range, 17.5–34.7 kg/m2) and mean neck circumference was 43.2 cm (range, 28–56 cm). The mean (± standard deviation) upward displacement of the endotracheal tube during neck extension was 7.17 ± 5.87 mm. Patients with a larger body mass index had a significantly greater amount of tube displacement (R2 = 0.67, p < 0.0001), as did patients with a smaller neck length (R2 = 0.48, p < 0.0001).

Conclusion:

Neck extension results in upward displacement of the endotracheal tube. The amount of displacement is significantly higher in patients with a larger body mass index or shorter neck length. This has particular relevance for nerve monitoring in thyroidectomy.

Keywords

ThyroidectomyRecurrent Laryngeal NerveEndotracheal Intubation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 10 , October 2015 , pp. 996 - 999
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented at the American Academy of Otolaryngology – Head and Neck Surgery Annual Meeting, 21 September 2014, Orlando, Florida, USA.

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