General considerations

General considerationsThe primary anesthetic concerns during neck surgery are establishing and maintaining a secure airway, tissue preservation, and nerve monitoring.

1. An armored endotracheal tube (e.g., Tovell) may be necessary to prevent kinking.
2. An elective tracheostomy under local anesthesia may be performed before induction of general anesthesia for some extensive procedures or for those with the potential for acute airway obstruction.
3. Teflon injection of the vocal cords must be performed during awake laryngoscopy to allow continuous assessment of voice quality. The procedure should be performed with adequate local anesthesia and light sedation.