• J Laryngol Otol · Oct 2015

    Endotracheal tube positioning during neck extension in thyroidectomy.

    • S D Sharma, G Kumar, H Kanona, T Jovaisa, and H Kaddour.
    • Department of Otorhinolaryngology,Queens Hospital,Romford,UK.
    • J Laryngol Otol. 2015 Oct 1; 129 (10): 996-9.

    ObjectiveTo evaluate the effect of body mass index and neck length on endotracheal tube movement during neck extension in thyroidectomy.MethodsA prospective study was conducted of 30 patients undergoing thyroidectomy during an 8-month period. Patient characteristics were recorded and endotracheal tube displacement was determined.ResultsMean 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).ConclusionNeck 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.

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