Intraoperative and postoperative complications during microlaryngeal surgery

Abstract

Theoretical basis: Patients presenting for microlaryngeal surgery may have a variety of comorbidities contributing to their voice symptoms and affecting anesthetic management. Results: Many patients presenting for laryngeal surgery have a long history of heavy smoking and drinking. Many patients who present for laryngeal surgery are elderly and have cardiovascular disease. The rate of difficult endotracheal intubation may reach almost 16% among patients presenting for ear, nose, or throat cancer surgery, which is on average six times higher than among the general surgical patient population. Loss of the airway on induction, requiring emergent cricothyrotomy or tracheostomy, can be sudden, especially in patients with critical airway obstruction. Prospective trials identify the incidence of dental trauma after suspension laryngoscopy at 0% to 6.5%, depending on the operator’s experience, methodology of the study, dental injury criteria, preexisting dentition status of the patient, and suspension technique used. Minor surgical complications, such as sore throat, mucosal injury (e.g., cuts, edema, hematoma), and cranial nerve dysfunction (e.g., lingual, glossopharyngeal, hypoglossal), are most commonly observed. The risk of postoperative airway compromise is significantly greater among the patients who underwent diagnostic laryngoscopy than those in the general surgical population. Conclusion: Patients presenting for microlaryngeal surgery may have a variety of intraoperative and postoperative complications.