Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) in type 1 thyroplasty

Klaus Torp, Zhou Li, Amy Rutt

Research output: Contribution to journalArticlepeer-review


Introduction: Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) has been shown to benefit oxygenation, ventilation, and upper airway patency in laryngeal surgery. Its use in thyroplasty procedures has not been described. We hypothesized that the addition of THRIVE during type 1 thyroplasty procedures increases patient's safety and decreases the risk of an obstructive airway, while also decreasing the FiO2 with potential pooling of oxygen under the drapes. Methods: This was a retrospective study of 80 patients carried out at Mayo Clinic Florida. Use of THRIVE for thyroplasty surgeries was introduced by the authors in 2016. All cases between 2016 and 2021 were analyzed. Patients who underwent thyroplasty surgery without the use of THRIVE were included as a control group. Results: A total of 80 patients underwent elective thyroplasty procedures, and 46 of them used the THRIVE technique. Median age was 61 years and 34 % were men. Patients with and without THRIVE were similar at baseline, but THRIVE patients had higher min SPO2 and lower HR end compared to patients without THRIVE. Normal BMI patients had significantly higher min SPO2 compared to either underweight or overweight BMI patients, but there was no strong linear relationship between BMI and intraoperative parameters. Conclusion: Our study is the first to demonstrate the use of THRIVE in type 1 thyroplasty in the literature. THRIVE facilitates oxygenation and ventilation of both the spontaneously breathing and the apneic patient. We have demonstrated that thyroplasty can be performed using high flow Optiflow® as the sole mechanism for oxygenation and ventilation.

Original languageEnglish (US)
Article number103574
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number5
StatePublished - Sep 1 2022


  • High flow nasal cannula
  • Thyroplasty
  • Transnasal Humidified Rapid Insufflation Ventilatory Exchange
  • Voice

ASJC Scopus subject areas

  • Otorhinolaryngology


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