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Immediate post-operative vocal changes in patients using laryngeal mask airway versus endotracheal tube

Published online by Cambridge University Press:  09 July 2007

A-L Hamdan ,
G Kanazi ,
C Rameh ,
H Rifai  and
A Sibai
A-L Hamdan*
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Faculty of Health Sciences, American University of Beirut, Lebanon
G Kanazi
Affiliation:
Department of Anesthesiology, Faculty of Health Sciences, American University of Beirut, Lebanon
C Rameh
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Faculty of Health Sciences, American University of Beirut, Lebanon
H Rifai
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Faculty of Health Sciences, American University of Beirut, Lebanon
A Sibai
Affiliation:
Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Lebanon
*
Address for correspondence: Dr Abdul-Latif Hamdan, Department of Otolaryngology, American University of Beirut, PO Box 11-0236, Beirut, Lebanon. Fax: 961 1 746660 E-mail: alhamdan@svclb.com
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Abstract

Objective and hypothesis:

(1) To examine the vocal symptoms and acoustic changes perceived in the short period immediately after laryngeal mask airway, and (2) to compare these findings in patients using laryngeal mask airway and endotracheal tube.

Materials and methods:

A total of 27 patients were enrolled. They were evaluated pre-operatively and then at 2 and 24 hours post-operatively. Patients were divided into two subgroups, laryngeal mask airway and endotracheal tube. Patients were asked about the presence or absence of the following: hoarseness, vocal fatigue, loss of voice, throat-clearing sensation, globus pharyngeus and throat pain. Patients then underwent acoustic analysis of their voice, measuring the average fundamental frequency, relative average perturbation, shimmer, noise to harmony ratio, voice turbulence index, habitual pitch and maximum phonation time.

Results:

In the laryngeal mask airway group, there was an increase in the incidence of all vocal symptoms two hours post-operatively, except for globus pharyngeus. The increase was statistically significant for vocal fatigue, loss of voice and throat pain. All the symptoms had reverted back to a normal baseline level by 24 hours. There was a decrease in the maximum phonation time and habitual pitch, with an increase in all the perturbation parameters, two hours post-operatively. At 24 hours, an increase was still present for shimmer, noise to harmony ratio and voice turbulence index. The maximum phonation time and habitual pitch reverted back to normal values.

In the endotracheal tube group, there was a significant increase two hours post-operatively in the incidence of hoarseness, loss of voice and throat pain. At 24 hours, all the symptoms reverted to baseline, except for vocal fatigue and throat pain. Two hours post-operatively, there was a significant decrease in maximum phonation time and an increase in all other parameters (however, the latter was significant only for relative average perturbation and noise to harmony ratio). At 24 hours, there was a significant increase in the maximum phonation time and a persistent (but statistically insignificant) increase in the average fundamental frequency, habitual pitch, noise to harmony ratio and voice turbulence index.

At two hours, there was more loss of voice and vocal fatigue in the laryngeal mask airway group, compared with the endotracheal tube group. At 24 hours, these symptoms were comparable in both groups. Comparing changes in acoustic parameters to baseline values in both groups, there were no statistically significant changes.

Conclusion:

Shortly after reversal of anaesthesia, laryngeal symptoms following laryngeal mask airway are no less significant than those experienced following endotracheal tube anaesthesia. Both methods can be regarded as nontraumatic, in view of the lack of significant vocal symptoms and acoustic changes 24 hours after anaesthesia.

Keywords

Endotracheal IntubationLaryngeal MasksVoiceComplications

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 8 , August 2008 , pp. 829 - 835
Copyright
Copyright © JLO (1984) Limited 2008

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References

1Peppard, S, Dickens, J. Laryngeal injury following short term intubation. Ann Otol Rhinol Laryngol 1983;92:327–30CrossRefGoogle ScholarPubMed
2Keane, W, Rowe, L, Denneny, J, Atkins, J. Complications of intubation. Ann Otol Rhinol Laryngol 1982;91:584–7CrossRefGoogle ScholarPubMed
3Beckford, NS, Mayo, R, Wilkinson, A 3rd, Tierney, M. Effects of short endotracheal intubation on vocal function. Laryngoscope 1990;100:331–6Google ScholarPubMed
4Balestrieri, F, Watson, C. Intubation granuloma. Otolaryngol Clin North Am 1982;15:567–79CrossRefGoogle ScholarPubMed
5Brain, AIJ. The laryngeal mask – a new concept in airway management. Br J Anaesth 1983;55:801–5CrossRefGoogle ScholarPubMed
6Alexander, CA, Leach, AB. Incidence of sore throats with the laryngeal mask. Anaesthesia 1989;44:791CrossRefGoogle ScholarPubMed
7Dingley, J, Whitehead, MJ, Wareham, K. A comparative study of the incidence of sore throat with the laryngeal mask airway. Anaesthesia 1994;49:251–4CrossRefGoogle ScholarPubMed
8Reiger, A, Brunne, B, Hass, I, Brummer, G, Spies, C, Stribel, HW et al. Laryngo-pharyngeal complaints following laryngeal mask airway and endotracheal intubation. J Clin Anaesth 1997;9:42–7CrossRefGoogle Scholar
9Horii, Y, Fuller, B. Selected acoustic characteristics of voices before intubation and after extubation. J Speech Hear Res 1990;33:505–10CrossRefGoogle ScholarPubMed
10Lesser, THJ, Williams, RG, Hoddinott, C. Laryngographic changes following endotracheal intubation in adults. Br J Dis Comm 1986;21:239–44CrossRefGoogle ScholarPubMed
11Yonick, T, Reich, A, Minifie, F, Fink, B. Acoustical effects of endotracheal intubation. J Speech Hear Disord 1990;55:427–33CrossRefGoogle ScholarPubMed
12Lee, SK, Hong, KH, Choe, H, Song, HS. Comparison of the effects of the laryngeal mask airway and endotracheal intubation on vocal function. Br J Anaesth 1993;71:648–50CrossRefGoogle ScholarPubMed
13Zimmert, M, Zwirnert, P, Kruset, E, Braun, U. Effects on vocal function and incidence of laryngeal disorder when using a laryngeal mask airway in comparision with an endotracheal tube. Eur J Anaesthesiol 1999;16:511–15CrossRefGoogle Scholar
14Finkelhor, BK, Titze, IR, Durham, PL. The effect of viscosity changes in the vocal folds on the range of oscillation. J Voice 1988;1:320–5CrossRefGoogle Scholar
15Tokics, L, Hedenstierna, G, Strandberg, A, Brismar, B, Lundquist, H. Lung collapse and gas exchange during general anesthesia: effects of spontaneous breathing, muscle paralysis and positive end-expiratory pressure. Anesthesiology 1987;66:157–67CrossRefGoogle ScholarPubMed
16Cartwright, P, Prys-Roberts, C, Gill, K, Dye, A, Stafford, M, Gray, A. Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans. Anesth Analg 1983;62:966–74CrossRefGoogle ScholarPubMed
17Figueredo, E, Vivar-Diago, M, Munoz-Blanco, F. Laryngo-pharyngeal complaints after use of the laryngeal mask airway. Can J Anesth 1999;46:220–5CrossRefGoogle ScholarPubMed
18Cros, AM, Pitti, R, Conil, C, Giraud, D, Verhulst, J. Severe dysphonia after use of laryngeal mask airway. Anesthesiology 1997;86:498–500CrossRefGoogle ScholarPubMed
19Verdolini, KM, Titze, IR, Druker, DG. Changes in phonation threshold pressure with induced conditions of hydration. J Voice 1990;4:142–51CrossRefGoogle Scholar
20Jiang, J, Verdolini, K, Aquino, B, Ng, J, Hanson, D. Effects of dehydration on phonation in excised canine larynges. Ann Otol Rhinol Laryngol 2000;109:568–75CrossRefGoogle ScholarPubMed