C-MAC D-Blade vs Macintosh for Postoperative Vocal Cord Evaluation

Inonu University102 enrolled

Overview

This study compares two different laryngoscopes-the C-MAC D-Blade videolaryngoscope and the Macintosh direct laryngoscope-for evaluating vocal cord mobility after thyroidectomy. Patients undergo standard anesthesia and intubation with one of the two devices. After surgery, vocal cord function is assessed to identify early postoperative vocal cord impairment. The study aims to determine whether videolaryngoscopy provides a more reliable and less traumatic method for postoperative vocal cord evaluation compared with the traditional Macintosh laryngoscope.

This prospective randomized study evaluates two laryngoscopic techniques used during endotracheal intubation in patients undergoing thyroidectomy. The C-MAC D-Blade videolaryngoscope provides an angulated blade and video-assisted view of the glottis, while the Macintosh laryngoscope represents the traditional direct visualization method. Because postoperative vocal cord impairment is an important early indicator of potential recurrent laryngeal nerve injury after thyroidectomy, accurate assessment immediately after surgery is clinically valuable. In this study, eligible patients were randomly assigned to intubation using either the C-MAC D-Blade videolaryngoscope or the Macintosh laryngoscope. All procedures were performed under standard anesthesia protocols by experienced anesthesiologists. After extubation and recovery, vocal cord mobility was evaluated using a standardized six-grade scoring system to assess postoperative vocal cord function. The study compares intubation characteristics, glottic views, optimization maneuvers, hemodynamic responses, and postoperative vocal cord mobility between the two devices. The primary aim is to determine whether videolaryngoscopy offers a more reliable and less traumatic method for postoperative vocal cord evaluation. Secondary objectives include evaluating ease of intubation, maneuver requirements, and perioperative physiological responses. The findings may help guide device selection for airway management in thyroid surgery and improve early detection of recurrent laryngeal nerve dysfunction.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

Conditions

Postoperative Vocal Cord Mobility Recurrent Laryngeal Nerve Injury

Interventions

Videolaryngoscope (C-MAC D-Blade)DEVICE

The C-MAC D-Blade videolaryngoscope was used to perform endotracheal intubation and to obtain a video-assisted view of the glottis. Its angulated blade design allows indirect visualization, providing improved glottic exposure during intubation and postoperative vocal cord mobility assessment

Direct Laryngoscope (Macintosh)DEVICE

The Macintosh direct laryngoscope was used for endotracheal intubation with conventional direct visualization of the glottis. This standard laryngoscopic technique was also used for postoperative assessment of vocal cord mobility.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria * Age between 20 and 70 years. * Height greater than 145 cm. * Body mass index (BMI) between 20 and 35 kg/m². * American Society of Anesthesiologists (ASA) physical status * Scheduled for elective thyroid surgery under general anesthesia. Exclusion Criteria * Prior neck surgery or radiotherapy * Large thyroid mass causing severe anatomical distortion. * Mouth opening less than 4 cm. * Short neck less than 6 cm in length. * Limited head and neck mobility * Unexpected difficult intubation. * Known history of recurrent laryngeal nerve injury * Presence of any neurological disorder.

Locations (1)

Inonu University

Malatya, Turkey (Türkiye)

Outcomes

Primary Outcomes

Postoperative Vocal Cord Mobility Score

Vocal cord mobility will be assessed using a standardized six-grade scoring system (I-VI) to detect postoperative vocal cord impairment after thyroidectomy.

Time frame: Within 30 minutes after extubation

Secondary Outcomes

Glottic View (Cormack-Lehane Grade)

The view of the glottis during intubation will be assessed using the Cormack-Lehane grading system.

Time frame: During intubation procedure

Need for Optimization Maneuvers

Whether external laryngeal maneuvers or additional attempts were required to facilitate intubation.

Time frame: During intubation procedure

Data from ClinicalTrials.gov

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