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Incidence of and Risk Factors Associated With Vocal Fold Hemorrhage Following Type I Thyroplasty With Gore-Tex Implant.
J Voice. 2020 Feb 17 [Online ahead of print]JV

Abstract

OBJECTIVES

The objectives of this study were to determine the rate of hemorrhage following type I thyroplasty performed exclusively with Gore-Tex implant and to define whether age, comorbidities, anticoagulation therapy, presence of vocal fold ectasia, and operative technique are associated with increased incidence of hemorrhage.

METHODS

Medical charts of 86 patients who underwent type I thyroplasty with Gore-Tex implant between the years 2013 and 2019 were reviewed retrospectively and divided into two groups based on presence or absence of postoperative vocal fold hemorrhage. Patients were examined on the day following surgery. Hemorrhage was defined as any submucosal erythema on the vocal fold even when isolated to the superior surface. Age, sex, medical comorbidities, preoperative medications with specific attention to anticoagulation therapy, American Society of Anesthesiology score (all procedures were performed under local anesthesia with sedation), operative notes, and pre- and poststroboscopy exams were compared between groups. Statistical analyses were done using Chi-Square (χ 2) Analysis and Student's t test. P values were considered statistically significant at the P < 0.05 level.

RESULTS

The rate of hemorrhage was 22.3%. There was a statistically significant difference in incidence of hemorrhage associated with a vocal fold varix on preoperative stroboscopic exam and history of discontinued anticoagulation therapy (1-week preoperatively). No difference was found for the other parameters studied.

CONCLUSION

Presence of vocal fold varix or ectasia and preoperative use of anticoagulation or antiplatelet therapy are associated with an increased risk of hemorrhage following type I Thyroplasty with Gore-Tex implant.

Authors+Show Affiliations

Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.Drexel University College of Medicine, Philadelphia, Pennsylvania.Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.Drexel University College of Medicine, Philadelphia, Pennsylvania.Temple University, Philadelphia, Pennsylvania.Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania; Lankenau Institute for Medical Research, Pennsylvania. Electronic address: rtsataloff@phillyent.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32081505

Citation

Eichorn, Daniel, et al. "Incidence of and Risk Factors Associated With Vocal Fold Hemorrhage Following Type I Thyroplasty With Gore-Tex Implant." Journal of Voice : Official Journal of the Voice Foundation, 2020.
Eichorn D, Park J, Alnouri G, et al. Incidence of and Risk Factors Associated With Vocal Fold Hemorrhage Following Type I Thyroplasty With Gore-Tex Implant. J Voice. 2020.
Eichorn, D., Park, J., Alnouri, G., Vance, D., Valentino, W., & Sataloff, R. T. (2020). Incidence of and Risk Factors Associated With Vocal Fold Hemorrhage Following Type I Thyroplasty With Gore-Tex Implant. Journal of Voice : Official Journal of the Voice Foundation. https://doi.org/10.1016/j.jvoice.2019.12.015
Eichorn D, et al. Incidence of and Risk Factors Associated With Vocal Fold Hemorrhage Following Type I Thyroplasty With Gore-Tex Implant. J Voice. 2020 Feb 17; PubMed PMID: 32081505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of and Risk Factors Associated With Vocal Fold Hemorrhage Following Type I Thyroplasty With Gore-Tex Implant. AU - Eichorn,Daniel, AU - Park,Jin, AU - Alnouri,Ghiath, AU - Vance,Dylan, AU - Valentino,William, AU - Sataloff,Robert T, Y1 - 2020/02/17/ PY - 2019/09/30/received PY - 2019/12/18/revised PY - 2019/12/18/accepted PY - 2020/2/22/entrez KW - Anticoagulation KW - Antiplatelet KW - Ectasia KW - Gore-Tex KW - Hemorrhage KW - Type I Thyroplasty KW - Varix JF - Journal of voice : official journal of the Voice Foundation JO - J Voice N2 - OBJECTIVES: The objectives of this study were to determine the rate of hemorrhage following type I thyroplasty performed exclusively with Gore-Tex implant and to define whether age, comorbidities, anticoagulation therapy, presence of vocal fold ectasia, and operative technique are associated with increased incidence of hemorrhage. METHODS: Medical charts of 86 patients who underwent type I thyroplasty with Gore-Tex implant between the years 2013 and 2019 were reviewed retrospectively and divided into two groups based on presence or absence of postoperative vocal fold hemorrhage. Patients were examined on the day following surgery. Hemorrhage was defined as any submucosal erythema on the vocal fold even when isolated to the superior surface. Age, sex, medical comorbidities, preoperative medications with specific attention to anticoagulation therapy, American Society of Anesthesiology score (all procedures were performed under local anesthesia with sedation), operative notes, and pre- and poststroboscopy exams were compared between groups. Statistical analyses were done using Chi-Square (χ 2) Analysis and Student's t test. P values were considered statistically significant at the P < 0.05 level. RESULTS: The rate of hemorrhage was 22.3%. There was a statistically significant difference in incidence of hemorrhage associated with a vocal fold varix on preoperative stroboscopic exam and history of discontinued anticoagulation therapy (1-week preoperatively). No difference was found for the other parameters studied. CONCLUSION: Presence of vocal fold varix or ectasia and preoperative use of anticoagulation or antiplatelet therapy are associated with an increased risk of hemorrhage following type I Thyroplasty with Gore-Tex implant. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/32081505/Incidence_of_and_Risk_Factors_Associated_With_Vocal_Fold_Hemorrhage_Following_Type_I_Thyroplasty_With_Gore-Tex_Implant L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(19)30463-1 DB - PRIME DP - Unbound Medicine ER -
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