Voice Handicap Index (VHI) changes after endotracheal intubation in head and neck, and abdominal surgery

Intubation and voice

Abstract

Background and purpose: Endotracheal intubation can carry a risk of mechanical trauma of laryngeal structures. Common postoperative symptoms can include voice changes, vocal fatigue, hoarseness, stridor, sore throat etc. Injuries can be caused by inappropriately chosen endotracheal tube size, longer duration of surgery, type of surgery, and some patient specific factors. The objective of this study is to examine effects of endotracheal intubation and different types of surgery on subjective voice quality measures in different postoperative time points. Also, some patient and operation specific factors will be examined.

Material and methods: Study included 80 adult patients, divided into three groups: parotid gland surgery, total thyroidectomy, and abdominal surgery. Sociodemographic data (age, gender, body mass index) were collected. Voice handicap index was used to assess functional, physical, and emotional impact of voice changes to patients’ lives. Anesthesia parameters were collected in the perioperative period.

Results: Significant changes in perceived symptoms were detected in all three groups of subjects, in different forms and duration. Perceived symptoms are the longest in patients who underwent total thyroidectomy, while the highest parameters in the first postoperative measurement are in patients who underwent parotid gland surgery.

Conclusions: Endotracheal intubation has an impact on perceived voice changes that occur after surgery in the head and neck area. Changes perceived after abdominal surgery were milder and shorter. Patient and surgery related factors have an important impact on intensity and duration of symptoms.