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NCT Number: NCT07277985

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

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.

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Key information

Conditions

Postoperative Vocal Cord Mobility Cranial Nerve Diseases Cranial Nerve Injuries Craniocerebral Trauma Laryngeal Diseases Laryngeal Nerve Injuries Nervous System Diseases Otorhinolaryngologic Diseases Recurrent Laryngeal Nerve Injuries Recurrent Laryngeal Nerve Injury Respiratory Tract Diseases Trauma, Nervous System Vagus Nerve Injuries Wounds and Injuries

Age range

20 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Inonu University

Malatya, 44280, Turkey (Türkiye)

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

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

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.

Other names: Direct Laryngoscope, Macintosh Blade

Primary outcomes

  1. Postoperative Vocal Cord Mobility Score

    Time frame: Within 30 minutes after extubation

    Vocal cord mobility will be assessed using a standardized six-grade scoring system (I-VI) to detect postoperative vocal cord impairment after thyroidectomy.

Secondary outcomes

  1. Glottic View (Cormack-Lehane Grade)

    Time frame: During intubation procedure

    The view of the glottis during intubation will be assessed using the Cormack-Lehane grading system.

  2. Need for Optimization Maneuvers

    Time frame: During intubation procedure

    Whether external laryngeal maneuvers or additional attempts were required to facilitate intubation.

Sponsors and collaborators

Lead sponsor

Inonu University

Other

Registry information

Official study title

Comparison of the C-MAC D-Blade Videolaryngoscope and the Macintosh Laryngoscope for Postoperative Vocal Cord Assessment After Thyroidectomy

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Dec 11, 2025
Registry last updated
Dec 12, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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