Difficult Laryngeal Exposure in Microlaryngoscopy: Can it be Predicted Preoperatively?

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• 作者：Roshna Rose Paul ; Ajoy Mathew Varghese…
• 关键词：Difficult laryngeal exposure (DLE) ; Microlaryngoscopy ; Pre ; op clinical parameters ; Neck circumference ; Atlanto ; occipital extension ; Odds Ratio
• 刊名：Indian Journal of Otolaryngology and Head & Neck Surgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：68
• 期：1
• 页码：65-70
• 全文大小：358 KB
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• 作者单位：Roshna Rose Paul (1)
  Ajoy Mathew Varghese (1)
  John Mathew (1)
  Ramanathan Chandrasekharan (1)
  Sophia Amalanathan (2)
  Syed Kamran Asif (1)
  Mary Kurien (1)
  
  1. Department of ENT, Christian Medical College, Vellore, 632004, Tamil Nadu, India
  2. Department of ENT, Indira Gandhi Medical College and Research Institute, Pondicherry, India
  
• 刊物主题：Otorhinolaryngology; Head and Neck Surgery;
• 出版者：Springer India
• ISSN：0973-7707

文摘

The aim of the present study was to identify preoperative clinical predictors for difficult laryngeal exposure (DLE) and to define a simple grading system for laryngeal exposure. This is a prospective descriptive study carried out in a tertiary teaching hospital in South India. Patients above 18 years undergoing microlaryngoscopy had presurgical evaluation of 11 physical parameters. Grading of Modified Cormack–Lehane Score (MCLS) and rigid laryngoscopy were done during procedure. On logistic regression analysis, with a 95 % confidence interval (CI) MCLS was found to be a statistically significant predictor (odds ratio 12). With 90 % CI, neck circumference, atlanto-occipital extension and MCLS were significant (odds ratio of 4, 4, 12 respectively). Neck circumference of more than 34.25 cm and limited atlanto-occipital extension of less than 19.50, predicts difficult laryngeal exposure. A simple grading system for laryngeal exposure during microlaryngoscopy is being proposed. MCLS grade more than 2a done intra operatively correlates well with difficult intubation.