Endotracheal Tube Safety During Electrodissection Tonsillectomy

Suction cautery and electrosurgical risks in otolaryngology

“…The majority of these 23 articles were published in Anesthesia journals with only three reports found in the otolaryngology literature [2,3,[14][15][16][17][18][19][20][21][22][23]. In contrast, another 11 articles pertained to events that occurred during oropharyngeal procedures whereby six were found in the otolaryngology literature [4][5][6][7][8][9]11,13,[24][25][26]. Table 1 summarizes the information from these reports.…”

“…Despite its success, electrical and thermal injuries do occur during electrosurgery and can result in devastating cosmetic, functional, or legal consequences. Commissure burns, mucosal injuries, aerodigestive fires, and endotracheal ignitions have been reported [2][3][4][5][6][7][8][9][10][11]. Recently we discovered a potential source of thermal injury to the velum, oral commissure and cheek from suction cautery units during routine adenoidectomy.…”

Electrosurgery in the Head and Neck

“…Endotracheal tube fires have been reported from electrodissection tonsillectomy. 45 Retrograde leakage of ventilating gases around an uncuffed endotracheal tube can produce a high oxygen concentration in the mouth, causing indirect ignition of the tube. Further, electrosurgery can also cause a fire or explosion in the presence of alcohol or other flammable solutions on the skin.…”

Effect of cuffed and uncuffed endotracheal tubes on the oropharyngeal oxygen and volatile anesthetic agent concentration in children

“…The latter is a concern not only related to exposure of healthcare providers to anesthetic gases, but also contamination of the oropharynx with a high concentration of oxygen. A high concentration of oxygen in the oropharynx is particularly relevant during surgical procedures on the oropharynx such as adenotonsillectomy where there is a risk of airway fire [5][6][7][8]. The purpose of the current prospective study was to assess the oropharyngeal oxygen concentration during adenotonsillectomy in infants and children.…”