UPPER AIRWAY EDEMA AFTER CAROTID ENDARTERECTOMY - THE EFFECT OF STEROID-ADMINISTRATION

The objective of this study was to evaluate the effect of preoperative steroid administration on the site and extent of upper airway edema a fter carotid endarterectomy. The design was a randomized, prospective, double-blind controlled trial. Thirty-eight patients undergoing elect ive carotid endarterectomy (17 patients were in the steroid-treated gr oup and 21 in the control group) were administered either 16 mg of dex amethasone or saline placebo prior to surgery. Computed tomograms (CT) scans of the neck were performed on the patients preoperatively and 2 4 h postoperatively. Measurements were taken from the CT scans of the airway transverse and anterior-posterior diameters at the levels of th e hyoid bone, arytenoid cartilage, and cricoid cartilage. No postopera tive neck hematomas were seen on the CT scans. Although neck edema was observed postoperatively, the upper airway dimensions were not statis tically significantly different between the steroid and the control gr oups. We conclude that steroid administration immediately preoperative ly has no clinical effect in reducing edema formation in the upper air way postcarotid endarterectomy.