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Is dysphonia permanent or temporary after anterior cervical approach?

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Abstract

The rate, causes and prognosis of dysphonia after anterior cervical approach (ACA) were investigated in our clinical series. During a 10-year interval, 235 consecutive patients with cervical disc disease underwent surgical treatment using anterior approach. Retrospective chart reviews showed recurrent laryngeal nerve (RLN) injury in 3 (1.27%) patients. All three patients were men and only one patient had multilevel surgery. These patients had RLN injury after virgin surgery. Laryngoscopic examination demonstrated unilateral vocal cord paralysis in all patients who had postoperative dysphonia. No permanent dysphonia was observed in our series and patients recovered after a mean of 2 months (range 1–3 months) duration. Dysphonia after ACA was a rare complication in our clinical series. Pressure on RLN or retraction may result in temporary dysphonia.

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References

  1. Bazaz R, Lee MJ, Yoo JU (2002) Incidence of dysphagia after anterior cervical spine surgery. A prospective study. Spine 27(22):2453–2458

    Article  PubMed  Google Scholar 

  2. Bertalanffy H, Eggert H (1989) Complications of anterior cervical discectomy without fusion in 450 consecutive patients. Acta Neurochir (Wien) 99:41–50

    Article  CAS  Google Scholar 

  3. Bulger RF, Rejowski JE, Beatty RA (1985) Vocal fold paralysis associated with anterior cervical fusion: considerations for prevention and treatment. J Neurosurg 62:657–661

    PubMed  CAS  Google Scholar 

  4. Cavo JW (1985) True vocal fold paralysis following intubation. Laryngoscope 95:1352–1358

    Article  PubMed  Google Scholar 

  5. Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:602–617

    Article  PubMed  CAS  Google Scholar 

  6. Cloward RB (1962) New method of diagnosis and treatment of cervical disc disease. Clin Neurosurg 8:93–132

    PubMed  CAS  Google Scholar 

  7. Dohn DF (1966) Anterior interbody fusion for treatment of cervical-disk conditions. JAMA 197:175–178

    Article  Google Scholar 

  8. Ebraheim NA, Lu J, Skie M et al (1997) Vulnerability of the recurrent laryngeal nerve in the anterior approach to the lower cervical spine. Spine 22:2663–2667

    Google Scholar 

  9. Flynn TB (1982) Neurologic complications of anterior cervical interbody fusion. Spine 7:536–539

    Article  PubMed  CAS  Google Scholar 

  10. Flynn TB (1987) Neurological complications of anterior cervical discectomy and interbody fusion: 1974 vs. 1984. Neurosurgery 21:119

    Google Scholar 

  11. Frempong-Boadu A, Houten JK, OsbornB, Opulencia J, Kells L, Guida DD, LeRoux PD (2002) Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech 15(5):362–368

    PubMed  Google Scholar 

  12. Geiger M, Roth PA, Wu JK (1995) The anterior cervical approach to the cervicothoracic junction. Neurosurgery 37:704–709

    Article  Google Scholar 

  13. Grisoli F, Graziani N, Fabrizi AP, Peragut JC, Vincentelli F, Diaz-Vasquez P (1989) Anterior discectomy without fusion for treatment of cervical lateral soft disc extrusion: a follow-up of 120 cases. Neurosurgery 24:853–858

    Article  PubMed  CAS  Google Scholar 

  14. Heeneman H (1973) Vocal fold paralysis following approaches to the anterior cervical spine. Laryngoscope 83:17–21

    Article  PubMed  CAS  Google Scholar 

  15. Jain KK (1974) Anterior approach to the cervical spine. Can Med Assoc J 111:49–50

    PubMed  CAS  Google Scholar 

  16. Jensen R, Jellis HWS, Thaliji Z et al (1998) Intraoperative recurrent laryngeal nerve monitoring during anterior cervical spine procedures with posterior pharyngeal electromyography. Annu Meeting Am Acad Neurosurg 133 (Abstract)

  17. Kriskovich MD, Apfelbaum RI, Haller JR (2000) Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury. Laryngoscope Sep 110(9):1467–1473

    Article  CAS  Google Scholar 

  18. Lim EK, Chia KS, Ng BK (1987) Recurrent laryngeal nerve palsy following endotracheal intubation. Anesth Intensive Care 15:342–345

    CAS  Google Scholar 

  19. Mayfield FH (1966) Cervical spondylosis: a comparison of the anterior and posterior approaches. Clin Neurosurg 13:181–187

    Google Scholar 

  20. Menck J, Gruber J, Lierse W (1990) Anterior approach to the cervical vertebrae and the location of the recurrent laryngeal nerve. Unfallchirurg 93:384–386

    PubMed  CAS  Google Scholar 

  21. Netterville JL, Koriwchak MJ, Winkle M, Courey MS, Ossi RH (1996) Vocal fold paralysis following anterior approach to the cervical spine. Ann Otol Rhinol Laryngol 105:85–91

    PubMed  CAS  Google Scholar 

  22. O’Shea J, Sundaresan N, Steinberger AA, Moore F (1996) Surgical approaches to the cervicothoracic junction. In: Menezes AH, Sonntag VKH (eds) Principles of spinal surgery. McGraw-Hill, New York, pp 1253–1261

    Google Scholar 

  23. Robinson RA, Smith GW (1955) Anterolateral cervical disc removal and interbody fusion for the cervical disc syndrome. Bull John Hopkins Hosp 96:223–224

    Google Scholar 

  24. Sidhu KS, Herkowitz HH (1999) Surgical management of cervical spine disease. In: Herkowitz HN, Garfin SR, Balderston RA, Eismont FJ, Bell GR, Wiesel SW (eds) The spine. W.B. Saunders, Philadelphia, pp 501–510

    Google Scholar 

  25. Sperry RJ, Johnson JO, Apfelbaum RI (1993) Endotracheal tube cuff pressure increases significantly during anterior cervical fusion with the Caspar instrumentation system. Anesth Analg 76:1318–1321

    PubMed  CAS  Google Scholar 

  26. Tew JM, Mayfield FH (1976) Complications of surgery of the anterior cervical spine. Clin Neurosurg 23:424–434

    PubMed  Google Scholar 

  27. Watters WC, Levinthal R (1994) Anterior cervical discectomy with and without fusion. Spine 19:2343–2347

    PubMed  Google Scholar 

  28. Weisberg NK, Spangler DM, Netterville JL (1997) Stretch-induced nerve injury as a cause of paralysis secondary to the anterior cervical approach. Otolaryngol Head Neck Surg 116:317–326

    Article  PubMed  CAS  Google Scholar 

  29. Winslow CP, Meyers AD (1999) Otolaryngologic complications of the anterior approach to the cervical spine. Am J Otolaryngol 20:16–27

    Article  PubMed  CAS  Google Scholar 

  30. Yamamoto I, Ikeda A, Shibuya N, Tsugane R, Sato O (1991) Clinical long-term results of anterior discectomy without interbody fusion for cervical disc disease. Spine 16:272–279

    Article  PubMed  CAS  Google Scholar 

  31. Yue WM, Brodner W, Highland TR (2005) Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5 to 11 year follow-up study. Eur Spine J Sep 14(7):677–682

    Article  Google Scholar 

  32. Yue WM, Brodner W, Highland TR (2005) Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Spine Oct 1 30(19):2138–2144

    Article  Google Scholar 

  33. Zeidman SM, Ducker TB, Raycroft J (1997) Trends and complications in cervical spine surgery: 1989–1993. J Spinal Disord 10:523–526

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Gülhane Military Medical Academy, 06018, Ankara, Turkey

    Serdar Kahraman, Sait Sirin, Ersin Erdogan, Cem Atabey, Mehmet Daneyemez & Engin Gonul

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  1. Serdar Kahraman
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  2. Sait Sirin
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  3. Ersin Erdogan
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  4. Cem Atabey
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  5. Mehmet Daneyemez
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  6. Engin Gonul
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Correspondence to Serdar Kahraman.

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Kahraman, S., Sirin, S., Erdogan, E. et al. Is dysphonia permanent or temporary after anterior cervical approach?. Eur Spine J 16, 2092–2095 (2007). https://doi.org/10.1007/s00586-007-0489-5

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  • DOI: https://doi.org/10.1007/s00586-007-0489-5

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