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 (eg, Tovell) may be necessary to prevent kinking.
2. An elective tracheostomy under local anesthesia may be performed before induction of GA for certain extensive procedures with anticipated difficult airway.
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.