title: A retrospective analysis of stridor after vestibular schwannoma surgery.
abstract: BACKGROUND
  Transient lower cranial nerve deficits may occur after surgery in the posterior cranial fossa. Stridor has been reported after cerebellopontine angle epidermoid resection. The aim of this retrospective study is to find out whether any preoperative, intraoperative, and postoperative factors lead to stridor after resection of vestibular schwannoma.
  
  
  METHODS
  Data of patients who underwent vestibular schwannoma resection from 2006 to 2011 were collected. We collected the following factors--age, sex, weight, diabetes, hypertension, preoperative cranial nerve deficits, tumor characteristics, intraoperative use of nitrous oxide, difficult endotracheal intubation, duration of surgery, postoperative cough and swallowing difficulty, limb weakness, and facial edema. Data of patients who developed stridor were compared with those who did not develop stridor. Odds ratio (OR) was used to assess the risk of developing stridor with each factor.
  
  
  RESULTS
  Thirteen patients (4.65%) developed stridor in immediate postextubation period. The risk of stridor was significantly high in patients who had difficult intubation (OR=9.56), longer duration of surgery (P=0.034) and in patients who developed facial edema (OR=13.33), upperlimb weakness (OR=32.88), poor cough (OR=7.72), and swallowing difficulty (OR=24.97) in the postoperative period.
  
  
  CONCLUSIONS
  The identification of the exact etiology of stridor often is difficult. Our results suggest that stridor may be more likely in patients who were difficult to intubate, had longer duration of surgery, who develop facial and neck edema and upperlimb weakness, poor cough, and swallowing after surgery. Establishing airway patency with intubation of the trachea may be required if patients develop oxygen desaturation due to stridor.
authors: *Departments of Anesthesiology †Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, India.
authors: Appavoo
authors: A
authors: Arulvelan
authors: Parthasarathi
authors: P
authors: Gayatri
authors: Vimalakumari
authors: V
authors: Smita
authors: Suresh N
authors: SN
authors: Nair
mesh_terms: D000328:Adult; D060666:Airway Extubation; D002530:Cerebellopontine Angle / Q000601:surgery; D004487:Edema / Q000150:complications; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000150:complications; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012135:Respiratory Sounds; D012189:Retrospective Studies; D012307:Risk Factors; D014139:Tracheostomy; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000209:etiology