Skip to main content

Advertisement

SpringerLink
Log in

Assessment of intracranial pressure with ultrasonographic measurement of optic nerve sheath diameter on patients undergoing suspension direct laryngoscopy

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The study aims to examine the effect on intracranial pressure by calculating the optic nerve sheath diameter (ONSD) using ultrasound in patients who underwent suspension direct laryngoscopy.

Methods

Thirty-three patients who underwent suspension direct laryngoscopy were included in this prospective observational study. ONSD measurement was performed using a high-frequency linear probe. The ONSD basal (T0) value was determined using ultrasound in the supine position before the induction. Ultrasonography was used to record ONSD in the Boyce Jackson position (T1) just before inserting the laryngeal blade, in the Boyce Jackson position just before removing the laryngeal blade (T2), and in the supine position (T3) just before extubation.

Results

A statistically significant rise (p < 0.001) was seen between the patients' baseline ONSD values and the values at T1, T2, and T3. The optic nerve sheat diameter level recorded prior to withdrawing the laryngeal blade (T2) was considerably greater than the ONSD level calculated instantly before insertion of the laryngeal blade (T1) (p < 0.001). The ONSD value prior to extubation (T3) following the removal of the laryngeal blade was considerably smaller than the ONSD value prior removing the laryngeal blade (T2) (p < 0.001).

Conclusions

This study found that when the laryngeal blade is mounted during the suspension direct laryngoscopy surgery, there is a significant increase in ultrasonographically measured ONSD and increased the ONSD even further during the time the mouth gag was remained in situ. This is the first research to indicate that measuring ONSD with ultrasonography during suspension direct laryngoscopy raises intracranial pressure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tong B, Fang R (2018) Analysis of pressure distribution during direct microlaryngoscopy. J Voice 32:122–125. https://doi.org/10.1016/j.jvoice.2017.04.012

    Article  PubMed  Google Scholar 

  2. Shribman AJ, Smith G, Achola KJ (1987) Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 59:295–299. https://doi.org/10.1093/bja/59.3.295

    Article  CAS  PubMed  Google Scholar 

  3. Hill AJ, Ro F, Underwood SM et al (1991) The haemodynamic effects of bronchoscopy Comparison of propofol and thiopentone with and without alfentanil pretreatment. Anaesthesia 46:266–270. https://doi.org/10.1111/j.1365-2044.1991.tb11493

    Article  CAS  PubMed  Google Scholar 

  4. Redmann AJ, White GD, Makkad B, Howell R (2016) Asystole from direct laryngoscopy: a case report and literature review. Anesth Prog 63:197–200

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hendrix RA, Ferouz A, Bacon CK (1994) Admission planning and complications of direct laryngoscopy. Otolaryngol Head Neck Surg 110:510–516. https://doi.org/10.1177/019459989411000607

    Article  CAS  PubMed  Google Scholar 

  6. Robinson PM (1991) Prospective study of the complications of endoscopic laryngeal surgery. J Laryngol Otol 105:356–358. https://doi.org/10.1017/S0022215100115981

    Article  CAS  PubMed  Google Scholar 

  7. Dip F, Nguyen D, Rosales A et al (2016) Impact of controlled intraabdominal pressure on the optic nerve sheath diameter during laparoscopic procedures. Surg Endosc 30:44–49. https://doi.org/10.1007/s00464-015-4159-0

    Article  PubMed  Google Scholar 

  8. Kimberly HH, Shah S, Marill K, Noble V (2008) Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med 15:201–204. https://doi.org/10.1111/j.1553-2712.2007.00031.x

    Article  PubMed  Google Scholar 

  9. Kumar A, Seth A, Prakash S et al (2016) Attenuation of the hemodynamic response to laryngoscopy and tracheal intubation with fentanyl, lignocaine nebulization, and a combination of both: a randomized controlled trial. Anesth Essays Res 10:661–666. https://doi.org/10.4103/0259-1162.191113

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lee DH, Park SJ (2011) Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation. Korean J Anesthesiol 60:422–427. https://doi.org/10.4097/kjae.2011.60.6.422

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Helmke K, Hansen HC (1996) Fundamentals of transorbital sonographic: Evaluation of optic nerve sheath expansion under intracranial hypertension. II Patient study. Pediatr Radiol 26:706–710. https://doi.org/10.1007/BF01383384

    Article  CAS  PubMed  Google Scholar 

  12. Sahu S, Panda N, Swain A et al (2021) Optic nerve sheath diameter: correlation with intra-ventricular intracranial measurements in predicting dysfunctional intracranial compliance. Cureus 13:e13008. https://doi.org/10.7759/cureus.13008

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hamaya Y, Dohi S (2000) Differences in cardiovascular response to airway stimulation at different sites and blockade of the responses by lidocaine. Anesthesiology 93:95–103. https://doi.org/10.1097/00000542-200007000-00018

    Article  CAS  PubMed  Google Scholar 

  14. Liu D, Li Z, Zhang X et al (2017) Assessment of intracranial pressure with ultrasonographic retrobulbar optic nerve sheath diameter measurement. BMC Neurol 17:1–7. https://doi.org/10.1186/s12883-017-0964-5

    Article  Google Scholar 

  15. Steinborn M, Fiegler J, Kraus V et al (2011) High resolution ultrasound and magnetic resonance imaging of the optic nerve and the optic nerve sheath: anatomic correlation and clinical importance. Ultraschall der Medizin 32:608–613. https://doi.org/10.1055/s-0029-1245822

    Article  CAS  Google Scholar 

  16. Ozsari E, Demirhan A (2021) Effect of bronchoscopy on intracranial hypertension during different regimen of sedation by optic nerve sheath diameter. Neurol Asia 26:795–800. https://doi.org/10.54029/2021MTD

    Article  Google Scholar 

  17. Tabari M, Alipour M, Ahmadi M (2013) Hemodynamic changes occurring with tracheal intubation by direct laryngoscopy compared with intubating laryngeal mask airway in adults: a randomized comparison trial. Egypt J Anaesth 29:103–107. https://doi.org/10.1016/j.egja.2012.11.003

    Article  Google Scholar 

  18. Barak M, Ziser A, Greenberg A et al (2003) Hemodynamic and catecholamine response to tracheal intubation: direct laryngoscopy compared with fiberoptic intubation. J Clin Anesth 15:132–136. https://doi.org/10.1016/S0952-8180(02)00514-7

    Article  PubMed  Google Scholar 

  19. Altiparmak B, Korkmaz Toker M, Uysal Aİ et al (2020) Evaluation of the effect of the mouth gag use on optic nerve sheath diameter of pediatric patients undergoing tonsillectomy or Adenotonsillectomy: an observational study. BMC Anesthesiol 20:1–8. https://doi.org/10.1186/s12871-020-01079-7

    Article  Google Scholar 

  20. Karali E, Demirhan A, Gunes A, Ural A (2020) Evaluation of the effect of Boyle-Davis mouth gag on intracranial pressure in patients undergoing adenotonsillectomy by using ultrasonographic optic nerve sheath diameter measurement. Int J Pediatr Otorhinolaryngol 131:109856. https://doi.org/10.1016/j.ijporl.2019.109856

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Golkoy, Bolu, 14280, Turkey

    Elif Karali, Akif Günes & Ahmet Ural

  2. Department of Anesthesiology and Reanimation, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey

    Abdullah Demirhan & Isa Yildiz

Authors
  1. Elif Karali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abdullah Demirhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akif Günes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isa Yildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ahmet Ural
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elif Karali.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karali, E., Demirhan, A., Günes, A. et al. Assessment of intracranial pressure with ultrasonographic measurement of optic nerve sheath diameter on patients undergoing suspension direct laryngoscopy. Eur Arch Otorhinolaryngol 280, 1835–1840 (2023). https://doi.org/10.1007/s00405-022-07709-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-022-07709-9

Keywords

Search

Navigation