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European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 2, pp 345–352 | Cite as

Laryngeal injuries following endotracheal intubation in ENT surgery: predictive value of anatomical scores

  • Arne Böttcher
  • Thomas Mencke
  • Amelie Zitzmann
  • Rainald Knecht
  • Nathan Jowett
  • Gabriele Nöldge-Schomburg
  • Hans Wilhelm Pau
  • Steffen Dommerich
Laryngology

Abstract

Endotracheal intubation has been associated with a threefold higher incidence of laryngopharyngeal complaints following anesthesia in comparison to laryngeal mask airway. Such complaints, including hoarseness and sore throat, have been reported in up to 90 % of patients within 24 h of extubation. The purpose of this study was to determine which preoperatively documented clinical and anatomic parameters are predictive of laryngo-pharyngeal trauma resulting from elective endotracheal intubation. Fifty-three patients undergoing ENT procedures requiring general anesthesia with endotracheal intubation were recruited. Pre and postoperative laryngostroboscopic examination was performed and findings correlated to preoperative clinical and anatomic parameters. Readily assessed anatomic parameters including height (>180 cm) and weight (>80 kg) correlated significantly to the Eckerbom grade of intubation-associated acute laryngeal injury (rs = 0.374; p = 0.006 and rs = 0.278; p = 0.044, respectively). The mandibular protrusion test also correlated significantly to the Eckerbom grade (rs = 0.462, p = 0.001) while the upper-lip-bite test showed significant correlation to impaired vocal fold oscillation (rs = 0.288, p = 0.036), with injury prediction sensitivities of 37.5 and 39.4 %, respectively. No parameters correlated to subjective complaints (n = 5, 9.2 %). This study provides suggestions on how to improve the classification of intubation-associated laryngeal injuries as well as providing the basis for larger clinical trials in other surgical subspecialties.

Keywords

Vocal fold sequelae Endotracheal intubation Laryngeal trauma Mandibular protrusion test Anatomical scores 

Notes

Conflict of interest

R. Knecht is a member of the Advisory Boards of Merck Serono, Sanofi Aventis, Boehringer Ingelheim and Bayer Healthcare, Leverkusen. The other authors report no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Arne Böttcher
    • 1
  • Thomas Mencke
    • 2
  • Amelie Zitzmann
    • 2
  • Rainald Knecht
    • 1
  • Nathan Jowett
    • 1
    • 3
  • Gabriele Nöldge-Schomburg
    • 2
  • Hans Wilhelm Pau
    • 4
  • Steffen Dommerich
    • 5
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Anaesthesia and Intensive Care MedicineUniversity of RostockRostockGermany
  3. 3.Department of Otolaryngology, Head and Neck SurgeryMcGill UniversityMontrealCanada
  4. 4.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of RostockRostockGermany
  5. 5.Department of Otorhinolaryngology, Head and Neck SurgeryCharité, Universitätsmedizin Campus MitteBerlinGermany

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