Tags

Type your tag names separated by a space and hit enter

Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients.
Otolaryngol Head Neck Surg. 2015 Dec; 153(6):1007-12.OH

Abstract

OBJECTIVES

The morbidity of glottic insufficiency resulting from unilateral vocal fold immobility may significantly compromise postoperative recovery in patients with decreased pulmonary reserve or inability to protect their airway. Injection medialization laryngoplasty is an effective means of treating glottic insufficiency due to unilateral vocal fold immobility. The purpose of this study is to present our experience with bedside transoral injection medialization laryngoplasty in the immediate postoperative period.

STUDY DESIGN

Case series with chart review.

SETTING

Academic tertiary care hospital.

SUBJECTS AND METHODS

Patient demographics, clinical characteristics, procedural details, and short-term outcome measures of oral intake were recorded in a cohort of 68 patients over 5 years with unilateral vocal cord paralysis who underwent injection medialization as a bedside procedure in the immediate postoperative period.

RESULTS

Mean time to injection was 8.2 days postoperatively. At the time of injection, 40 of 68 patients were nil per os. Seventy percent (28 of 40) had their diet advanced to adequate oral intake within 5 days of injection. Greater than half of the injections (36 of 68) were performed in the intensive care unit. No complications were noted, and all patients in this cohort were able to tolerate the bedside injection.

CONCLUSION

Bedside injection medialization laryngoplasty in the immediate postoperative period via the transoral approach can be performed in patients, even in the intensive care unit, while on anticoagulation, and may be of benefit for hospitalized patients with unilateral vocal fold immobility. Further studies quantifying improvement in voice and swallowing data are merited.

Authors+Show Affiliations

Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA Barbu.Anca@mgh.harvard.edu.Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA.Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA.NorthShore University HealthSystem Department of Surgery, Evanston, Illinois, USA.Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26307574

Citation

Barbu, Anca M., et al. "Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 153, no. 6, 2015, pp. 1007-12.
Barbu AM, Gniady JP, Vivero RJ, et al. Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients. Otolaryngol Head Neck Surg. 2015;153(6):1007-12.
Barbu, A. M., Gniady, J. P., Vivero, R. J., Friedman, A. D., & Burns, J. A. (2015). Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 153(6), 1007-12. https://doi.org/10.1177/0194599815601393
Barbu AM, et al. Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients. Otolaryngol Head Neck Surg. 2015;153(6):1007-12. PubMed PMID: 26307574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients. AU - Barbu,Anca M, AU - Gniady,John P, AU - Vivero,Richard J, AU - Friedman,Aaron D, AU - Burns,James A, Y1 - 2015/08/25/ PY - 2015/04/01/received PY - 2015/07/28/accepted PY - 2015/8/27/entrez PY - 2015/8/27/pubmed PY - 2016/4/5/medline KW - injection medialization KW - larynx/surgery KW - vocal fold paralysis SP - 1007 EP - 12 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 153 IS - 6 N2 - OBJECTIVES: The morbidity of glottic insufficiency resulting from unilateral vocal fold immobility may significantly compromise postoperative recovery in patients with decreased pulmonary reserve or inability to protect their airway. Injection medialization laryngoplasty is an effective means of treating glottic insufficiency due to unilateral vocal fold immobility. The purpose of this study is to present our experience with bedside transoral injection medialization laryngoplasty in the immediate postoperative period. STUDY DESIGN: Case series with chart review. SETTING: Academic tertiary care hospital. SUBJECTS AND METHODS: Patient demographics, clinical characteristics, procedural details, and short-term outcome measures of oral intake were recorded in a cohort of 68 patients over 5 years with unilateral vocal cord paralysis who underwent injection medialization as a bedside procedure in the immediate postoperative period. RESULTS: Mean time to injection was 8.2 days postoperatively. At the time of injection, 40 of 68 patients were nil per os. Seventy percent (28 of 40) had their diet advanced to adequate oral intake within 5 days of injection. Greater than half of the injections (36 of 68) were performed in the intensive care unit. No complications were noted, and all patients in this cohort were able to tolerate the bedside injection. CONCLUSION: Bedside injection medialization laryngoplasty in the immediate postoperative period via the transoral approach can be performed in patients, even in the intensive care unit, while on anticoagulation, and may be of benefit for hospitalized patients with unilateral vocal fold immobility. Further studies quantifying improvement in voice and swallowing data are merited. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/26307574/Bedside_Injection_Medialization_Laryngoplasty_in_Immediate_Postoperative_Patients_ L2 - http://journals.sagepub.com/doi/full/10.1177/0194599815601393?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -