Consistent Technique Limits Suspension Laryngoscopy Complications

Larner, Sean P.; Fornelli, Rick; Griffith, Shane

doi:10.1055/s-0039-1684036

Cited by 12 publications

(19 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this data collection period, we had no incidences of major complications such as severe cardiovascular instability, esophageal perforation or permanent tongue sequelae, incurring only mild temporary complications (Table 3). Reassuringly, most large reported series also report an absence of severe complications (1,8,(11)(12)(13)(14)(15)(16)(17)(18)(19) and the literature on these subjects is limited to isolated case reports (20). The main complication experienced by our patients, in line with other studies (18), was that of temporary sore throat (66% of patients).…”

Section: Discussionsupporting

confidence: 83%

“…Our cases therefore tend to have shorter procedural times, and the absence of adjuvant radiotherapy renders our patients' oropharyngeal tissues less stiff, and dentition more stable, than that seen by the Head & Neck team. This makes comparison with other reported series difficult (1,8,12,15) as most report a mix of benign and malignant cases and have much longer average procedural durations. Our findings of common and uncommon procedural complications therefore pertain specifically to benign laryngology and are not generalizable to mixed or Head & Neck patient populations.…”

Section: Discussionmentioning

confidence: 88%

“…This high success rate, together with our low complication rates, compares well with series from other centers specializing in laryngeal surgeries (Table 4), and is likely multifactorial in nature. We are the UK referral service for tertiary airway surgery -as such we have a high turnover of cases, including many patients undergoing regular repeated procedures under our care (albeit fewer in this time period due to COVID-19), and we have an experienced surgical, anesthetic and nursing team who regularly work together (1). Other factors which we feel contribute to this high success rate include correct patient positioning (no shoulder roll and head forward position), routine use of supraglottic jet ventilation, infrequent endotracheal intubation and our predilection for the Dedo-Pilling laryngoscope (although it must be stated that use of the Lindholm laryngoscope was not correlated with increased complications) (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…Suspension laryngoscopy (SL) is a staple procedure in otolaryngology which facilitates bimanual laryngeal instrumentation under direct vision, thus permitting microlaryngeal surgery using a wide variety of surgical techniques including cold steel excision, laser and radiofrequency ablation. With a careful and standardized approach, SL is usually efficient and bloodless with minimal post-procedure discomfort following reversal of general anesthesia (1). As with every procedure, there are recognized complications, the rates of which vary widely in the global literature.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures

Rotman

Rouhani

Thong

et al. 2020

Preprint

View full text Add to dashboard Cite

Objectives: In most cases, suspension laryngoscopy (SL) is efficient, bloodless and with minimal post-procedure discomfort. We aimed to identify predictive patient factors for acceptable surgical views at SL as well as quantify our tertiary airway unit’s complication rates. Design: Prospective cohort study of 150 consecutive microlaryngoscopy procedures involving SL over an 8-month period between November 2019 and July 2020. Patients were assessed pre-operatively for pre-existing oral, temporomandibular, dental, pharyngeal or laryngeal pathology, interincisor distance and qualitative gross limitations to neck extension and forward head posture. Intraoperatively, the laryngoscopic view was graded by anesthetic and surgical teams, and complications were recorded on patient interview in recovery. Setting: Tertiary adult airway service for predominantly benign pathology. Results: Adequate surgical views were obtained in 149/150 procedures. BMI and limitations to chin and neck movement had mild positive correlations with more difficult views in their own rights, but did not correlate with a statistically significant increase in complications. There was a negative correlation between age and interincisor gap (p=0.014), and wider mouth opening correlated with a lower incidence of sore throat (p=0.023). Macroglossia showed a statistically significant positive correlation with tongue symptoms (p=1.611x10-8). Conclusion: In the context of an experienced airway unit with a high caseload of predominantly benign pathology, SL is very effective and safe with low associated morbidity and no mortality. Patient-reported neck and chin movement were found to correlate well with the surgical view obtained. The most common complication of SL is temporary sore throat and there remain recognized risks of temporary tongue and dental symptoms.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures

Rotman

Rouhani

Thong

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Ultimately, 23 references meeting the selection criteria were included. 7-29 A flow diagram detailing this process is shown in Figure 3 .…”

Section: Methodsmentioning

confidence: 99%

Comparison of Dental Injury Rates in Perioperative Intubation and Suspension Laryngoscopy for Otolaryngology Procedures

2021

View full text Add to dashboard Cite

Objective Direct laryngoscopy is an essential skill during perioperative intubation and otolaryngology procedures. Dental injury is a common complication of direct laryngoscopy. However, the technique and tools used by anesthesiologists, nurse anesthetists, and others during perioperative intubation and by ear, nose, and throat surgeons for their procedures are different. The purpose of this review is to explore the literature for all studies detailing rates of dental injury in each of these settings and to compare them to see if the approaches have a significant difference in rate of dental injury. Data Sources PubMed. Review Methods A comprehensive search of PubMed was performed through February 2021 with search terms “dental” and “intubation” or “laryngoscopy.” PRISMA guidelines were followed. Studies documenting rates of dental injuries during intubation or during laryngologic procedures were included, and the 2 groups were compared. Results Twenty-three studies met inclusion criteria: 17 in the perioperative intubation group and 6 in the suspension laryngoscopy group. There was an increased incidence of dental injury in the perioperative intubation group (4.86%) as compared with the suspension laryngoscopy group (1.70%). Conclusions The difference in dental injury rate between the groups could be due to the differences in direct laryngoscopy technique or tools used, the presence vs absence of a dental guard, or a combination of these factors. More studies need to be performed to develop definitive and specific conclusions to recommend changes that prevent dental injury.

show abstract