title: A prospective randomized controlled trial of the laryngeal mask airway versus the endotracheal intubation in the thyroid surgery: evaluation of postoperative voice, and laryngopharyngeal symptom.
abstract: BACKGROUND
  The present study was performed to determine whether thyroidectomy patients undergoing general anesthesia provided with a laryngeal mask airway (LMA) have a lower risk of voice-related complications and laryngopharyngeal symptoms than those undergoing endotracheal intubation (ETI).
  
  
  METHODS
  In a prospective, double-blinded, randomized clinical trial, we studied 64 patients undergoing elective thyroid lobectomy between July 2013 and February 2014. Acoustic analyses were performed preoperatively and at 48 h and 2 weeks postoperatively. The voice handicap index (VHI), M.D. Anderson dysphagia index (MDADI), and laryngopharyngeal symptom score (LPS) were determined preoperatively and at 24 h, 48 h, 1 week, and 2 weeks post-thyroidectomy.
  
  
  RESULTS
  In acoustic analysis, jitter, shimmer and noise-to-harmonic ratio showed significantly better results in the LMA group than the ETI group 48 h after surgery, but there was no difference at 2 weeks. The incidence of postoperative lower-pitched voice in the LMA group was also significantly lower than that in the ETI group. In the LMA group, the VHI, MDADI, and LPS were better compared to those in the ETI group at 24 h postoperatively, and improved to the preoperative state within 1 week. However, those in the ETI group remained poorer than the preoperative values 1 week after surgery.
  
  
  CONCLUSIONS
  Use of the LMA in general anesthesia for thyroid surgery has advantages over the ETI in decreasing patients' subjective and objective voice symptoms, reducing the duration of symptoms, and relieving the laryngopharyngeal symptoms.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors: Byung-Joon
authors: BJ
authors: Chun
authors: Ja-Sung
authors: JS
authors: Bae
authors: So-Hui
authors: SH
authors: Lee
authors: Jin
authors: J
authors: Joo
authors: Eun-Sung
authors: ES
authors: Kim
authors: Dong-Il
authors: DI
authors: Sun
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods*; D003680:Deglutition Disorders / Q000209:etiology*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007818:Laryngeal Diseases / Q000209:etiology*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000209:etiology*; D011184:Postoperative Period; D011446:Prospective Studies; D013961:Thyroid Gland; D013965:Thyroidectomy; D014832:Voice Disorders / Q000209:etiology*