Sawatsubashi M.a,b,c· Umezaki T.b,c· Kikuchi Y.c· Adachi K.b,c· Nakagawa T.c

Author affiliations

aDepartment of Otolaryngology-Head and Neck Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan
bDepartment of Speech and Hearing Sciences, International University of Health and Welfare, and the Voice and Swallowing Center, Fukuoka Sanno Hospital, Fukuoka, Japan
cDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

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Article / Publication Details

Received: September 16, 2022
Accepted: February 20, 2023
Published online: April 26, 2023

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

Abstract

Introduction: Type I thyroplasty is one of the most useful surgeries for unilateral vocal fold paralysis. The study objective was to determine whether type I thyroplasty is safe and perioperative antithrombotic management is acceptable in patients undergoing antithrombotic therapy. Methods: This is a single-hospital retrospective cohort study. The records of 204 patients who underwent type I thyroplasty at a Japanese university hospital, between 2008 and July 2018 were reviewed. We compared the prothrombin time international normalized ratio, prothrombin time, operative time, intraoperative blood loss, and intra- and postoperative complications between patients who did and did not receive antithrombotic therapy. Results: Of 204 patients, 51 (25%) received antithrombotic therapy (antithrombotic group). The remaining 153 patients were assigned to the control group. There were no significant differences in operative time, intraoperative blood loss, or intraoperative complications between the two groups. Sixteen (31%) patients in the antithrombotic group had a hemorrhage or hematoma in the vocal fold mucosa postoperatively, no patient had airway obstruction necessitating tracheostomy, and all patients recovered with follow-up observation only. There were no cases of intraoperative or postoperative complications, such as ischemic heart disease, ischemic stroke, or deep vein thrombosis. Conclusion: Type I thyroplasty with careful pre- and postoperative management is safe in patients undergoing antithrombotic therapy.

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References Gotoh S, Yasaka M, Nakamura A, Kuwashiro T, Okada Y. Management of antithrombotic agents during surgery or other kinds of medical procedures with bleeding: the MARK study. J Am Heart Assoc. 2020;9(5):e012774. Hsueh WD, Hwang PH, Abuzeid WM. Perioperative management of antithrombotic therapy in common otolaryngologic surgical procedures: state of the art review. Otolaryngol Head Neck Surg. 2015;153(4):493–503. Umezaki T. Tips and pitfalls of Type I thyroplasty. Koutou. 2011;23(2):82–6. Montgomery WW, Montgomery SK. Montgomery thyroplasty implant system. Ann Otol Rhinol Laryngol Suppl. 1997 Sep;170:1–16. Ioannidis JPA. The proposal to lower P value thresholds to .005. JAMA. 2018;319(14):1429–30. Isshiki N, Okamura H, Ishikawa T. Thyroplasty type I (lateral compression) for dysphonia due to vocal cord paralysis or atrophy. Acta Otolaryngol. 1975;80(5–6):465–73. Isshiki N. Progress in laryngeal framework surgery. Acta Otolaryngol. 2000;120 (2):120–7. Eichorn D, Park J, Alnouri G, Vance D, Valentino W, Sataloff RT. Incidence of and risk factors associated with vocal fold hemorrhage following type I thyroplasty with gore-tex implant. J Voice. 2021;35(4):655–8. Koenen W, Kunte C, Hartmann D, Breuninger H, Moehrle M, Bechara FG, et al. Prospective multicentre cohort study on 9154 surgical procedures to assess the risk of postoperative bleeding: a DESSI study. J Eur Acad Dermatol Venereol. 2017;31(4):724–31. Oltmann SC, Alhefdhi AY, Rajaei MH, Schneider DF, Sippel RS, Chen H. Antiplatelet and anticoagulant medications significantly increase the risk of postoperative hematoma: review of over 4500 thyroid and parathyroid procedures. Ann Surg Oncol. 2016 May;23(9):2874–82, Weinman EC, Maragos NE. Airway compromise in thyroplasty surgery. Laryngoscope. 2000;110(7):1082–5. Abraham MT, Gonen M, Kraus DH. Complications of type I thyroplasty and arytenoid adduction. Laryngoscope. 2001;111(8):1322–9. Paknezhad H, Pasick LJ, Sataloff RT. Prevalence and long-term consequences of vocal fold hemorrhage in patients who underwent microscopic laryngeal surgery or type I thyroplasty. J Voice. 2021;35(1):143–50. Burger W, Chemnitius JM, Kneissl GD, Rücker G. Low-dose aspirin for secondary cardiovascular prevention: cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation–review and meta-analysis. J Intern Med. 2005;257(5):399–414. Jethwa AR, Khariwala SS. When should therapeutic anticoagulation be restarted following major head and neck surgery?Laryngoscope. 2018;128(5):1025–6. Article / Publication Details

Received: September 16, 2022
Accepted: February 20, 2023
Published online: April 26, 2023

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

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