O’Brien, Joseph; Zarro, Christopher; Gelb, Daniel; Bhargava, Amit; Ludwig, Steven
Purpose of review: The intent of this article is to review the postoperative complications of dysphagia and dysphonia after cervical surgery. The focus is on prevention, early identification, and initial treatment.
Recent findings: Anterior cervical procedures have become commonplace in spine surgery. Within the past year the incidence of postoperative dysphagia and dysphonia has been estimated to be as much as 47%. Recent studies have implicated damage to the recurrent laryngeal, hypoglossal, or superior laryngeal nerves as a causative factor. Damage may occur from direct injury during surgery or as a result of extrinsic pressure from retractors and the endotracheal tube. A recent study has shown no increase in the incidence of nerve injury when right-sided and left-sided approaches are compared. Diagnostic modalities include physical examination, plain radiographs, and endoscopy. Advances in treatment use diet modification, therapy, and autologous and allogeneic substance injection into the vocal cords.
Summary: Operative modalities for the cervical spine continue to evolve. As techniques progress efforts must be made to prevent, identify, and treat complications that may arise.
Current Opinion in Orthopedics. 16(3):184-188, June 2005.