Summary
Background
The aim of this study is to investigate the feasibility of using indirect laryngoscopy for the diagnosis of difficult intubations in patients who are undergoing microlaryngeal surgery.
Methods
In the pre-anesthetic examination the thyromental distance, sternomental distance, interincisor distance, neck circumference, modified Mallampati scores, and Wilson risk scores were measured. An otolaryngologist conducted an indirect laryngoscopic assessment. Direct laryngoscopic profiles were classified according to their Cormack–Lehane scores.
Results
Forty patients underwent microlaryngeal surgery. Their mean ages, neck circumferences, Cormack–Lehane scores of the patients who had intubation difficulties were statistically significantly higher than those who did not have intubation difficulties (p < 0.05). The significant differences between the indirect laryngoscopic assessment distributions of patients who either had or did not have intubation difficulty were assessed (p < 0.05).
Conclusions
Indirect laryngoscopic assessment is a simple and valuable technique that can be used for the diagnosis of difficult intubation in patients who are undergoing microlaryngeal surgery.
Zusammenfassung
Grundlagen
Ziel dieser Studie war es, zu untersuchen, inwiefern die Verwendung der indirekten Laryngoskopie für die Diagnostik von schwierigen Intubationen bei Patienten, die sich einer Mikrolaryngoskopie unterziehen, geeignet ist.
Methodik
Im Laufe der voranästhetischen Untersuchung wurden die thyromentale Distanz, die sternomentale Distanz, der Schneidezahnabstand, der Genickumfang und die angepassten Mallampati-Scores sowie die Wilson-Risiko-Scores gemessen. Ein Otolaryngologe hat eine indirekte Laryngoskopie durchgeführt. Direkte laryngoskopische Profile wurden anhand ihres Cormack-Lehane-Scores eingestuft.
Ergebnisse
Vierzig Patienten haben sich einer Mikrolaryngoskopie unterzogen. Das Durchschnittsalter, der durchschnittliche Genickumfang und die Cormack-Lehane-Scores der Patienten, die Intubationsschwierigkeiten hatten, waren statistisch betrachtet erheblich höher als die der Patienten, die keine solche Schwierigkeiten hatten (p < 0,05). Die signifikanten Unterschiede zwischen den Ergebnisverteilungen der indirekten laryngoskopischen Untersuchung für Patienten, die jeweils Intubationsschwierigkeiten hatten bzw. nicht hatten, wurden ausgewertet (p < 0,05).
Schlussfolgerungen
Die indirekte laryngoskopische Untersuchung stellt ein einfaches und wertvolles Verfahren dar, das für die Diagnostik der Intubationsschwierigkeiten bei Patienten, die sich einer Mikrolaryngoskopie unterziehen, verwendet werden kann.
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Türkay, M., Şentürk, T., Arslan, B.Y. et al. Indirect laryngoscopic assessment for the diagnosis of difficult intubation in patients undergoing microlaryngeal surgery. Wien Med Wochenschr 166, 62–67 (2016). https://doi.org/10.1007/s10354-015-0419-9
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DOI: https://doi.org/10.1007/s10354-015-0419-9