Endotracheal tube positioning during neck extension in thyroidectomy.
OBJECTIVE
To evaluate the effect of body mass index and neck length on endotracheal tube movement during neck extension in thyroidectomy.


METHODS
A prospective study was conducted of 30 patients undergoing thyroidectomy during an 8-month period. Patient characteristics were recorded and endotracheal tube displacement was determined.


RESULTS
Mean body mass index was 27.8 kg/m2 (range, 17.5-34.7 kg/m2) and mean neck circumference was 43.2 cm (range, 28-56 cm). The mean (± standard deviation) upward displacement of the endotracheal tube during neck extension was 7.17 ± 5.87 mm. Patients with a larger body mass index had a significantly greater amount of tube displacement (R2 = 0.67, p < 0.0001), as did patients with a smaller neck length (R2 = 0.48, p < 0.0001).


CONCLUSIONS
Neck extension results in upward displacement of the endotracheal tube. The amount of displacement is significantly higher in patients with a larger body mass index or shorter neck length. This has particular relevance for nerve monitoring in thyroidectomy.
Department of Otorhinolaryngology,Queens Hospital,Romford,UK.
S D
SD
Sharma
Department of Otorhinolaryngology,Queens Hospital,Romford,UK.
G
G
Kumar
Department of Otorhinolaryngology,Queens Hospital,Romford,UK.
H
H
Kanona
Department of Otorhinolaryngology,Queens Hospital,Romford,UK.
T
T
Jovaisa
Department of Otorhinolaryngology,Queens Hospital,Romford,UK.
H
H
Kaddour
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology*; D009929:Organ Size; D056888:Patient Positioning / Q000379:methods*; D011446:Prospective Studies; D013965:Thyroidectomy / Q000379:methods*
Endotracheal Intubation; Recurrent Laryngeal Nerve; Thyroidectomy