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

NCT07277985 | Completed

• 1 other identifier: 2022/115
• Study Type: interventional
• Target: 102
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Postoperative Vocal Cord Mobility; Recurrent Laryngeal Nerve Injury

Keywords

Thyroidectomy; Macintosh Laryngoscope; Videolaryngoscope; Airway Management; Vocal Cord Mobility; Recurrent Laryngeal Nerve

Outcome Measures

Primary Outcomes (1)

• 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.

  Within 30 minutes after extubation

Secondary Outcomes (2)

• Glottic View (Cormack-Lehane Grade)

  During intubation procedure

• Need for Optimization Maneuvers

  During intubation procedure

Study Arms (2)

C-MAC D-Blade Videolaryngoscope

EXPERIMENTAL

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.

Device: Videolaryngoscope (C-MAC D-Blade)

Macintosh Laryngoscope

ACTIVE COMPARATOR

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

Device: Direct Laryngoscope (Macintosh)

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

C-MAC D-Blade Videolaryngoscope

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.

Also known as: Direct Laryngoscope, Macintosh Blade

Macintosh Laryngoscope

Eligibility Criteria

• Age: 20 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Inonu University: lead

Study Sites (1)

Inonu University

Malatya, 44280, Turkey (Türkiye)

Location

Related Publications (7)

• Chilkoti GT, Gupta A, Bhandari P, Mohta M. Techniques of detecting recurrent laryngeal nerve palsy in patients undergoing thyroid surgery: Pearls and pitfalls. J Anaesthesiol Clin Pharmacol. 2024 Apr-Jun;40(2):199-205. doi: 10.4103/joacp.joacp_346_22. Epub 2024 Apr 8.

  PMID: 38919442 RESULT

• Sastre JA, Lopez T, Del Barrio ME. Airtraq(R) videolaryngoscope for assessing vocal cord mobility at the end of thyroidectomy. J Clin Anesth. 2017 May;38:3-4. doi: 10.1016/j.jclinane.2017.01.012. Epub 2017 Jan 12. No abstract available.

  PMID: 28372672 RESULT

• Priyanka AS, Nag K, Hemanth Kumar VR, Singh DR, Kumar S, Sivashanmugam T. Comparison of King Vision and Truview Laryngoscope for Postextubation Visualization of Vocal Cord Mobility in Patients Undergoing Thyroid and Major Neck Surgeries: A Randomized Clinical Trial. Anesth Essays Res. 2017 Jan-Mar;11(1):238-242. doi: 10.4103/0259-1162.200240.

  PMID: 28298792 RESULT

• Kundra P, Kumar V, Srinivasan K, Gopalakrishnan S, Krishnappa S. Laryngoscopic techniques to assess vocal cord mobility following thyroid surgery. ANZ J Surg. 2010 Nov;80(11):817-21. doi: 10.1111/j.1445-2197.2010.05441.x. Epub 2010 Aug 19.

  PMID: 20969690 RESULT

• Chilkoti GT, Bhandari P, Mohta M, Saxena AK, Kapoor R. Comparison of the Efficacy of Macintosh Laryngoscope Versus Airtraq Videolaryngoscope for Visualization of Laryngeal Structures at the End of Thyroidectomy: A Randomized Control Study. Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3191-3198. doi: 10.1007/s12070-023-03828-9. Epub 2023 Jun 15.

  PMID: 37974697 RESULT

• Gangappa RB, Kenchannavar MB, Chowdary PB, Patanki AM, Ishwar M. Total Thyroidectomy for Benign Thyroid Diseases: What is the Price to be Paid? J Clin Diagn Res. 2016 Jun;10(6):PC04-7. doi: 10.7860/JCDR/2016/18733.7991. Epub 2016 Jun 1.

  PMID: 27504342 RESULT

• AlOsaif ZA, Al Bisher HM, Elshnawie HA, Al-Hariri MT. The Impact of Thyroidectomy and Lobectomy on Patients' Health-Related Quality of Life, Eastern Region, Saudi Arabia. Clin Pract. 2024 Jun 29;14(4):1251-1263. doi: 10.3390/clinpract14040101.

  PMID: 39051295 RESULT

MeSH Terms

Conditions

Recurrent Laryngeal Nerve Injuries

Condition Hierarchy (Ancestors)

Laryngeal Nerve Injuries; Laryngeal Diseases; Respiratory Tract Diseases; Otorhinolaryngologic Diseases; Vagus Nerve Injuries; Cranial Nerve Injuries; Cranial Nerve Diseases; Nervous System Diseases; Craniocerebral Trauma; Trauma, Nervous System; Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Masking Details: Randomization was performed by an anesthesiologist not involved in the study procedures, ensuring that the participant, care provider, and investigator remained masked to group assignment. The outcomes assessor was not masked.
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Surgery

Model Details: Participants were randomly assigned in a 1:1 ratio to either the C-MAC D-Blade videolaryngoscope group or the Macintosh laryngoscope group. Both groups were followed and evaluated in parallel throughout the study.

Study Record Dates

• First Submitted: December 1, 2025
• First Posted: December 11, 2025
• Study Start: January 23, 2023
• Primary Completion: May 26, 2023
• Study Completion: May 26, 2023
• Last Updated: December 12, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)