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BJA Advance Access originally published online on June 25, 2009
British Journal of Anaesthesia 2009 103(3):452-455; doi:10.1093/bja/aep169
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© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Prolonged hoarseness and arytenoid cartilage dislocation after tracheal intubation

H. Yamanaka1, Y. Hayashi1,*, Y. Watanabe2, H. Uematu1 and T. Mashimo1

1 Department of Anesthesiology, Osaka University Medical School, 2-2, Yamada-oka, Suita, Osaka 565-0871, Japan
2 Department of Oto-Rhino-Laryngology, International University of Health and Welfare Mita Hospital, Tokyo, Japan

* Corresponding author. E-mail: yhayashi{at}anes.med.osaka-u.ac.jp

Background: Hoarseness is a common complication after tracheal intubation and prolonged hoarseness may be very limiting for a patient. This study was designed to examine the duration of hoarseness after tracheal intubation and to identify risk factors that may increase the duration of hoarseness.

Methods: We prospectively studied 3093 adult patients (aged 18–77 yr), over a 3 yr period who required tracheal intubation. Postoperative hoarseness was assessed on the day of operation and on postoperative days 1, 3, and 7 by standardized interview by the resident anaesthetist managing the patient. If postoperative hoarseness was still present on postoperative day 7, the patient was followed up until complete resolution. We evaluated age, gender, weight, Cormack grades, duration of intubation, and the anaesthetic agents used as factors affecting the duration of hoarseness after tracheal intubation.

Results: Hoarseness was observed in 49% of patients on the day of surgery and in 29%, 11%, and 0.8% on 1, 3, and 7 postoperative days, respectively. Multiple regression analysis showed that patient age and duration of intubation, but not gender, weight, Cormack grades, or the agents used, were significant predictors of increased duration of hoarseness after tracheal intubation. We found three patients with arytenoid cartilage dislocation (0.097%) in our study population.

Conclusions: The age of the patient and duration of intubation were significant factors in the duration of hoarseness after tracheal intubation. In addition, the incidence of arytenoid cartilage dislocation was 0.097%.

Keywords: airway, complications; complications, arytenoid dislocation; complications, intubation tracheal; complications, hoarseness; larynx, vocal cords


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