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

Inonu University

Status: Completed

Conditions: Recurrent Laryngeal Nerve Injury; Postoperative Vocal Cord Mobility

Treatments: Device: Direct Laryngoscope (Macintosh); Device: Videolaryngoscope (C-MAC D-Blade)

Study type: Interventional

Funder types: Other

Identifiers

NCT07277985

2022/115

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 102 patients

Sex: All

Ages: 20 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

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.

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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102 participants in 2 patient groups

C-MAC D-Blade Videolaryngoscope

Experimental group

Description:

Patients in this group were intubated using the C-MAC D-Blade videolaryngoscope to facilitate glottic visualization and to perform postoperative vocal cord mobility assessment.

Treatment:

Device: Videolaryngoscope (C-MAC D-Blade)

Macintosh Laryngoscope

Active Comparator group

Description:

Patients in this group were intubated with the traditional Macintosh direct laryngoscope, which was also used for postoperative assessment of vocal cord mobility.

Treatment:

Device: Direct Laryngoscope (Macintosh)