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Tuesday, June 15, 2021

Predictors of Increased Surgical Drain Output following Type I Thyroplasty for Glottic Insufficiency

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Objective

To determine predictors of increased drain output following type I thyroplasty for glottic insufficiency.

Study Design

Retrospective chart review.

Methods

A retrospective review was conducted for patients who underwent type I thyroplasty for glottic insufficiency from 2014–2019. The primary outcome was 24-hour drain output. Increased drain output was defined as >50th percentile for the sample. Univariate logistic regression models and linear regression models were used.

Results

There were 84 patients with a mean age of 58.9 (SD 16.9) years. Twenty-four–hour drain output ranged from 0 to 29 mL with a mean of 9.47 (SD 6.49) mL. Patients with a history of tobacco use (OR 3.33; 95% CI, 1.24–8.95; P = .017) and prior neck surgery (OR 3.52; 95% CI, 1.26 to 9.83; P = .016) were significantly more likely to have increased drain output following surgery; these patients had a mean increase in 24-hour drain output of 3.51 mL (95% CI, 0.52 to 6.51; P = .022) and 1.74 mL (95% CI, –1.41 to 4.89; P = .274), respectively. Type of implant (Gore-Tex vs. Silastic; P = .425) and operative technique (unilateral vs. bilateral; P = .506) were not significantly associated with drain output.

Conclusion

History of tobacco use and prior surgery of the neck predict increased drain output following type I thyroplasty surgery. These patients may derive the most benefit from surgical drain placement. More research is needed to confirm these findings and elucidate potential mechanisms.

Level of Evidence

4 Laryngoscope, 131:1557–1560, 2021

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