Anterior Tonsillar Pillar Perforation During Glidescope® Video Laryngoscopy

Malik, Asif; Frogel, Jonathan

doi:10.1213/01.ane.0000264321.04403.06

Cited by 78 publications

(65 citation statements)

References 3 publications

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“…This suggests that, if the GRS is used for GVL intubation, malleable stylets should also be available. There was no evidence of oral trauma in any patient during this study, but rare cases have been reported with both GRS 7 and malleable stylet [4][5][6] use. Considering that the GRS is markedly more rigid than the malleable stylet, there could well be increased potential for trauma using the GRS.…”

Section: Discussionmentioning

confidence: 86%

“…Résultats : Le TTI médian était de 42,7 sec (intervalle interquartile (IQR) 38,7) pour le groupe GRS comparé à 39,9 sec (IQR 34,2) pour le groupe témoin (P = 0,07). Le score EVA médian pour la facilité d'intubation était de 20 (IQR 12,0) …”

Section: Méthode : Quatre-vingts Patients Nécessitant Une Intubation unclassified

“…It consistently provides a good glottic view, 1 but advancing the endotracheal tube (ETT) through the vocal cords can be difficult 2,3 and trauma is possible. [4][5][6][7] Due to the curvature of the GVL blade, a stylet must be used to position the ETT tip at the glottic opening. 2 Various authors have recommended different curvatures of the ETT/stylet to optimally place it into the trachea, including matching the blade's 60° angle, 1,A configuring the ETT with a 90° bend, 2 or using a "J-shaped" ETT.…”

Section: Conclusion : Dans Un Groupe D'opérateurs Expérimentés Se Sermentioning

confidence: 99%

“…L'opérateur a évalué la facilité d'intubation à l'aide d'une échelle visuelle analogique (EVA). Le nombre de tentatives d'intubation, le nombre d'échecs, le grade d'intubation et le recours à une manipulation laryngée externe ont été notés.Résultats : Le TTI médian était de 42,7 sec (intervalle interquartile (IQR) 38,7) pour le groupe GRS comparé à 39,9 sec (IQR 34,2) pour le groupe témoin (P = 0,07). Le score EVA médian pour la facilité d'intubation était de 20 (IQR 12,0) …”

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The GlideScope®-specific rigid stylet and standard malleable stylet are equally effective for GlideScope® use

Turkstra

Harle

Armstrong

et al. 2007

Can J Anesth/J Can Anesth

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Purpose:The GlideScope® videolaryngoscope usually provides excellent glottic visualization, but directing an endotracheal tube (ETT) through the vocal cords can be challenging. The goal of the study was to compare the dedicated GlideScope®-specific rigid stylet to the standard malleable stylet, assessed by time to intubation (TTI).Methods: Eighty patients requiring orotracheal intubation for elective surgery were randomly allocated to either the GlideScope® rigid stylet (GRS) or a standard malleable stylet to facilitate intubation using the GlideScope®. Time to intubation was recorded by blinded assessors; operators were blinded until after laryngoscopy. The operator assessed the ease of intubation using a visual analogue scale (VAS). The number of intubation attempts, number of failures, glottic grades, and use of external laryngeal manipulation were documented. Results:The median TTI was 42.7 sec (inter-quartile range (IQR) 38.9-56.7) for the GRS group compared to 39.9 sec (IQR 34.1-48.2) for the control group (P = 0.07). The median VAS score for ease of intubation was 20 (IQR 12.0-33.0) for the GRS group compared to 18 (IQR 9.5-29.5) for the control group (P = 0.21). There was no significant difference in TTI or VAS between stylets. The overall incidence of a Cormack-Lehane grade I or II glottic view was 98%. Conclusions:In a group of experienced operators using the GlideScope®, the dedicated GRS and the standard malleable ETT stylet are equally effective in facilitating endotracheal intubation. le temps requis pour l'intubation (TTI). Méthode : Quatre-vingts patients nécessitant une intubation orotrachéale pour une chirurgie élective ont été randomisés à être intubés à l'aide soit du mandrin rigide GlideScope® (GRS), soit du mandrin flexible standard pour faciliter l'intubation avec le GlideScope®. Le temps requis pour l'intubation a été mesuré par des évaluateurs en aveugle ; les opérateurs étaient également en aveugle jusqu'à ce que la laryngoscopie soit terminée. L'opérateur a évalué la facilité d'intubation à l'aide d'une échelle visuelle analogique (EVA). Le nombre de tentatives d'intubation, le nombre d'échecs, le grade d'intubation et le recours à une manipulation laryngée externe ont été notés.Résultats : Le TTI médian était de 42,7 sec (intervalle interquartile (IQR) 38,7) pour le groupe GRS comparé à 39,9 sec (IQR 34,2) pour le groupe témoin (P = 0,07). Le score EVA médian pour la facilité d'intubation était de 20 (IQR 12,0)

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Section: Discussionmentioning

confidence: 86%

Section: Méthode : Quatre-vingts Patients Nécessitant Une Intubation unclassified

Section: Conclusion : Dans Un Groupe D'opérateurs Expérimentés Se Sermentioning

confidence: 99%

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The GlideScope®-specific rigid stylet and standard malleable stylet are equally effective for GlideScope® use

Turkstra

Harle

Armstrong

et al. 2007

Can J Anesth/J Can Anesth

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“…Since the introduction of the video laryngoscope in 2002, a series of case reports have been published that document the complications encountered with its use (Table 1). [100][101][102][103][104][105][106][107][108][109][110][111][112] The most common complication is injury to the soft palate, although injuries to the teeth, larynx, tongue, and retromolar trigone have also been described. [110][111][112] The oropharynx is specifically at risk of injury because the video laryngoscope causes the tonsillar pillars to elevate and stretch anteriorly, making them more prone to injury as the tube is being advanced.…”

Section: Larynxmentioning

confidence: 99%

Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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Although endotracheal intubation is commonly performed in the hospital setting, it is not without risk. In this article, we review the impact of endotracheal intubation on airway injury by describing the acute and long-term sequelae of each of the most commonly injured anatomic sites along the respiratory tract, including the nasal cavity, oral cavity, oropharynx, larynx, and trachea. Injuries covered include nasoseptal injury, tongue injury, dental injury, mucosal lacerations, vocal cord immobility, and laryngotracheal stenosis, as well as tracheomalacia, tracheoinnominate, and tracheoesophageal fistulas. We discuss the proposed mechanisms of tissue damage that relate to each and present their most common clinical manifestations, along with their respective diagnostic and management options. This article also includes a review of complications of airway management pertaining to video laryngoscopy and supraglottic airway devices. Finally, potential strategies to prevent intubation-associated injuries are outlined.

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