Effect of general anesthesia on voice

BackgroundTransient voice change after surgical operations under general anesthesia has generally been attributed to vocal fold trauma. The aim of this study was to examine the effect of general anesthesia on voice in order to aid the early detection and prevention of these changes.Patients and methodsThis study was carried out on 100 patients who were scheduled for a variety of elective surgical procedures under general anesthesia. They were 47 males, ranging in age from 6 to 55 years, and 53 females with the same range of age. Evaluation of vocal functions was carried out at three intervals, 1 day before operation, 1 day after operation and 2 weeks later.All patients were subjected to analysis of their complaints (using Arabic Voice Handicap index, VHI), auditory perceptual assessment of their voice (APA), and laryngeal assessment using telescopic rigid orolaryngoscopy.ResultsAmong 95 patients (using endotracheal tube), ten patients complained of postoperative voice change, ranging in severity from mild in 8, moderate in 1, and severe in one patient. After 2 weeks, one patient was still complaining of severe voice change. There was postextubation mild to moderate voice change in 10 patients. The pitch was decreased in three patients, strained and leaky voice quality was perceived in one patient, strained voice was perceived in three patients, whereas breathy quality was perceived in one patient. Irregular quality was perceived in five patients; after 1 week, there was an improvement in all the perceived parameters; however, persistent mild dysphonia was perceived in one patient. The telescopic rigid orolaryngoscopy, performed 1 day after extubation, indicated evidence of traumatic laryngeal manifestations in 40 patients; erythema and congestion in 39 patients and in one patient intubation granuloma was recorded. Using laryngeal mask airway in 5 patients had no effect on their voice postoperatively.ConclusionTraumatic manifestations of the laryngeal structures that occur during intubation are the most common causes of postoperative dysphonia, with a tendency toward a regressive course of the resulting dysphonia. As such, it is important to establish an early diagnosis and adopt preventive measures.