{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T17:20:52Z","timestamp":1770484852617,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T00:00:00Z","timestamp":1387756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantify the incidence of postoperative voice, swallowing, and other problems, including time to resolution following anterior transcervical approaches to the cervical spine, and to assess surgical factors associated with outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Historical cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>One hundred eighty\u2010eight consecutive patients with cervical spine disease who underwent an anterior transcervical approach to the spine by a single head and neck surgeon over a 4\u2010year time period. Rather than primary, single\u2010level approaches, all patients in this study had multilevel, high\u2010cervical (above C4), low\u2010cervical (below C6), and\/or revision approaches. Postoperative voice, swallowing, and other complaints were measured as well as time to resolution using Kaplan\u2010Meier method. Surgical factors related to outcomes were analyzed using regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Follow\u2010up was available for 129 patients, with average and median time of 35\u00a0months. Seventy\u2010seven patients (60%) had a postoperative issue, including 35 patients (27%) with postoperative voice complaint, 62 patients (48%) with postoperative swallowing complaint, and 16 patients (12%) with other problems. Swallowing and voice complaints persisted beyond 1 year in 28% and 9% of patients, respectively. Approaching spinal levels above C4 and exposing more than 3 spinal levels were 2 factors significantly related to voice and swallowing problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a high incidence of subjective voice and swallowing complaints following transcervical anterior approaches to the spine, and such complaints can persist beyond 1 year in many patients. Exposure of more than 3 spinal levels or above level C4 are 2 factors significantly associated with outcome.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599813515414","type":"journal-article","created":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T23:24:44Z","timestamp":1387841084000},"page":"259-265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Factors Predictive of Voice and Swallowing Outcomes after Anterior Approaches to the Cervical Spine"],"prefix":"10.1002","volume":"150","author":[{"given":"Saral","family":"Mehra","sequence":"first","affiliation":[{"name":"Yale University School of Medicine Section of Otolaryngology New Haven Conneticutt USA"},{"name":"New York Presbyterian Hospital of Weill Cornell Medical College Department of Otolaryngology\u2013Head and Neck Surgery New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas 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