gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Intraoperative Measurement of Pharynx / Esophagus Retraction during Anterior Cervical Fusion (ACF)

Intraoperative Messung der Pharynx-/Ösophagus-Retraktion bei anteriorer zervikaler Fusion (ACF)

Meeting Abstract

  • corresponding author Oliver Heese - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • V. Klotz-Regener - Klinik für Neurochirurgie, Diakonissen Krankenhaus, Flensburg
  • R. Buchalla - Klinik für Neurochirurgie, Diakonissen Krankenhaus, Flensburg
  • F. Schröder - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • P. Kunkel - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • L. Papavero - Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.13.01

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0125.shtml

Veröffentlicht: 23. April 2004

© 2004 Heese et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Pressure induced by retractor blades on pharynx/esophagus was measured intraoperatively in order to investigate whether postoperative swallowing disturbances are related to amount and duration of retraction of the pharynx / esophagus wall

Methods

73 patients underwent anterior cervical fusion. An online pressure transducer (16x10x2mm) was applied to the rear side of the medial retractor blade (epiluminal pressure, Epi-P) in all patients. In 31 cases a cylindric transducer (17x5mm) was preoperatively inserted into the pharynx/esophagus under fluoroscopy at the level to be operated on (endoluminal pressure, Endo-P). Mean arterial pressure (MAP) and endotracheal cuff pressure (ETCP) were recorded additionally. The patients rated swallowing difficulty during the first postoperative week by a ten-point score system. A control group of 32 lumbar microdiscectomy patients was evaluated for swallowing disturbances.

Results

Mean EPI-P following retractor opening was 97mmHg. Thirty and 60 minutes later the EPI-P decreased to 80 and 75%, respectively. Mean basal Endo-P was 8mmHg and increased to 20mmHg after retractor placement. An adjustment to 76% of the initial value occurred within the first hour. 34 patients complained of swallowing disturbances according to our protocol. No correlation between amount and duration of retraction pressure and swallowing disturbances was observed. In the control arm only one out of 32 patients complained of swallowing disturbances.

Conclusions

To our knowledge this is the first report on intraoperative measurement of epiluminal pressure and endoluminal pressure exposed to the pharynx/esophagus during ACF. The postulated hypothesis of a correlation between postoperative swallowing disturbances and amount of intraoperative pharynx/esophagus retraction could not be confirmed. However the absence of impaired deglutition in the control group suggests that a local phenomenon must be causative for swallowing disturbances following ACF.