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Endotracheal tube positioning during neck extension in thyroidectomy

  • S D Sharma (a1), G Kumar (a1), H Kanona (a1), T Jovaisa (a1) and H Kaddour (a1)...



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


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.


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).


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.


Corresponding author

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:


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



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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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