December 29, 2013

How Long Do Swallowing and Voice Problems Last After C-Spine Surgery ACDF?

I often see patients for swallowing and/or voice difficulties after cervical spine surgery (ACDF). In the vast majority of cases, reassurance that such "side effects" are not uncommon is the only thing I need to provide after a complete exam.

After all, both the voice box and swallowing tube are manipulated and pushed over to one side in order to perform cervical spine surgery from an anterior approach. Check out the video below that illustrates how this happens.

Beyond reassurance, the next question patients have is how long before things go back to normal. Until now, that was a hard question to answer.

A recent report was able to provide some numbers I can now use to help explain to patients. After anterior approaches to cervical spine surgery:

• 60% had a postoperative issue, including 27% with postoperative voice complaint and 48% with postoperative swallowing complaint
Swallowing complaints that lasted beyond 1 year occurred in 28%
• Voice complaints that lasted over 1 year occurred in 9%
• Approaching spinal levels above C4 and exposing more than 3 spinal levels were 2 factors that significantly resulted in voice and swallowing problems

In certain patients with more extreme swallowing difficulties, barium swallow studies may be ordered. Swallow therapy can be helpful as well.

Should vocal cord paralysis be seen on endoscopy, voice therapy and even vocal cord medialization injections can be performed to alleviate voice problems.

With respect to swallowing problems, pharyngeal muscle weakness is the main contributor to dysphagia. [link]

Factors Predictive of Voice and Swallowing Outcomes after Anterior Approaches to the Cervical Spine. Otolaryngol Head Neck Surg. 2013 Dec 23. [Epub ahead of print]

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

1 comment:

Unknown said...

Had c3 c4 fused in November 2017.went in for 2week follow up and dr.said harwdware came loose had to go back under and have revision. 2 week checkup everything still intact. He also took old hardware out on c5c6c7. Still sore
But the swallowing and my voice. I can't yell at anyone it is all hoarse and raspy.if I talk to long this also happens
Swallowin is a crap shoot.
Mainly soft and frustrated. I want those plate taken out. It is a pain. It is taking a toll on me.Go back to the dr in 4 weeks. So once I have DDD going to have the rest of lumbar fused with hardware.And he is taking old out. Because the new would be on top of it.lower part of my neck I had done in 08 was a piece of cake compared to this. I hope I make it thru all of this.
Good luck to everyone going thru this

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