Utilidad del score predictivo de Cameron para la realización de traqueostomía electiva después de cirugía tumoral oral

Benatar-Haserfaty, J.; Picón-Molina, M.; Meléndez-Salinas, D.A.; Palacios-López, C.

doi:10.1016/j.redar.2014.02.009

Cited by 5 publications

(10 citation statements)

References 14 publications

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“…Airway obstruction has been reported to severely affect patients in cases of anterior mandibular resection alone, primary tumor resection alone, and neck dissection alone. 9,27 Resection or dissection of the genioglossus, geniohyoid, and mylohyoid muscles prevents lifting of the hyoid bone, which may exacerbate airway obstruction, even in patients who appear to be at low risk. This type of moderate surgical invasiveness is managed in a general hospital unit rather than in an intensive care unit, which engenders a risk of delayed response to airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Scoring Systems for Airway Management After Oral Cancer Surgery: A Retrospective Study

Abe

Umemura²,

Hayashi

et al. 2021

Ann Otol Rhinol Laryngol

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Objective: Postoperative airway obstruction following oral cancer surgery is difficult to predict. Scoring systems used to assess the need for tracheotomy use risk factors as criteria. We aimed to examine whether these clinical scoring systems can predict airway obstruction following oral cancer surgery. Methods: We assessed 95 patients who underwent oral cancer surgery without tracheotomy under general anesthesia between January 2007 and April 2019. We reviewed multiple factors from the patients’ medical records, including age, sex, tumor site, body mass index, tumor stage, type of surgery, airway management method, Cameron and Gupta scores, and postoperative airway complications. Results: Tumors were located in the maxilla ( n = 14), buccal mucosa ( n = 13), mandible ( n = 14), floor of the mouth ( n = 6), and tongue ( n = 48). Twenty-seven patients (28.4%) were graded as Stage 1, 37 patients (38.9%) as Stage 2, 9 patients (9.5%) as Stage 3, and 3 (3.2%) patients as Stage 4. Nine patients (9.5%) had local recurrences, and ten patients (10.5%) had neck metastases. Postoperative oxygen administration alone failed to improve dyspnea in 4 patients (4.2%). The median Cameron scores between patients with and without airway trouble were not significantly different ( P = 0.226). However, a significant difference was observed in median Gupta scores between patients with and without airway trouble ( P = 0.01). We created a receiver operating characteristic curve to predict postoperative airway trouble based on the preoperative Gupta score; the area under the curve was 0.856 (95% confidence interval: 0.61-1). A Gupta score cutoff value of 3.0 had a sensitivity of 92.3% and specificity of 75.0%. Conclusions: Screening based on the Gupta score appears to be effective in predicting postoperative airway obstruction. We propose that this screening tool can be used to better plan tracheotomy and other airway management strategies during preoperative patient assessment.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Scoring Systems for Airway Management After Oral Cancer Surgery: A Retrospective Study

Abe

Umemura²,

Hayashi

et al. 2021

Ann Otol Rhinol Laryngol

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“…This scoring system was created by combining elements used in the evaluation on the basis of the same items. Benatar–Haserfaty et al [ 23 ] analyzed the application of elective tracheostomy with a cutoff Cameron score of ≥5. The results showed a diagnostic sensitivity value of 0.7 (95% confidence interval [CI] 0.57–0.82), diagnostic specificity value of 0.9 (95% CI 0.79–0.99), PPV of 0.9 (95% CI 0.81–0.99), and NPV of 0.67 (95% CI 0.54–0.8).…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Lee et al [ 22 ] reported that they could not identify correlations between the need for tracheotomy and the clinical findings in patients with oral cancer based on the Cameron score. Moreover, Benatar–Haserfaty et al [ 23 ] conducted an analysis based on the Cameron score for performing elective tracheotomy in oral cancer surgery. The analysis revealed high selectivity and PPV (90% for both), low sensitivity (70%), and NPV (67%), making it difficult to determine whether tracheotomy was necessary.…”

Section: Discussionmentioning

confidence: 99%

“…However, there have been reported cases of severe outcomes resulting from occlusions, even if resection was performed only on the frontal part of the mandible, as well as in cases in which only the primary lesion was excised or a single neck dissection was performed. [ 22 , 23 ] Even in cases that appear to be low risk, resection or abrasion of the genioglossus muscle, geniohyoid muscle, or mylohyoid muscle may cause deterioration of airway obstruction due to the loss of support of the hyoid bone. Such procedures with moderate surgical invasion are managed outside the intensive care unit and therefore pose a risk of delayed treatment of airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

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The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery

et al. 2021

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In oral cancer surgery, the decision to perform a tracheotomy is often determined by the surgeon. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy and examined the degree of agreement between the surgeon's decision and the indications of various scoring systems. We identified 110 patients who were surgically treated for oral cancer. Of these, 67 patients (44 men and 23 women) who underwent resection and reconstruction were retrospectively analyzed. To derive the score, we evaluated the endpoint of the airway management score using clinical records and images. We divided the patients into two groups based on the Cameron and Gupta scores (tracheotomy and no-tracheotomy groups) and evaluated the degree of agreement with the surgeon's decision by calculating the k coefficient. The k coefficients of the Gupta and Cameron scores were 0.61 (95% confidence interval [CI]: 0.40-0.82) and 0.60 (95% CI: 0.38-0.82), respectively. The clinical evaluation of the k coefficient indicated that the Cameron and Gupta scores agreed fairly with the surgeon's decision. In this study, the Cameron and Gupta scores fairly agreed with the decision of experienced surgeons and were confirmed as acceptable guides for making clinical judgments.

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“…Una TE presenta una morbilidad global del 8%, siendo la mitad complicaciones graves como la infección, la hemorragia, la neumonía, la fístula traqueoesofágica, la obstrucción, mal posicionamiento de la cánula, la reapertura del estoma y la estenosis traqueal, sin embargo estas complicaciones son más frecuentes en caso de TU. La traqueostomía, en el cancer laríngeo, es el principal factor de riesgo para la recurrencia del estoma un rango de 5%-15% de todos los pacientes, y se asocia con una supervivencia global del 15% a 2 años [32], [33].…”

Section: Vía Aérea Quirúrgicaunclassified

Consideraciones en la valoración de la vía aérea en el paciente con tumor de cabeza y cuello

López¹,

Barrios²,

Guzmán³

et al. 2023

Rev. chil. anest.

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Today, neoplastic disease affecting the patient's head and neck that is amenable to surgical intervention is one of the greatest challenges for anesthesiologists, since few situations present a greater potential risk of airway changes than the patient undergoing surgery for head and neck cancer. Accurate prediction of difficult airway management can reduce potential complications; however, these predictions are of limited value in patients already presenting with head and neck pathology. The (NAP4) Fourth National Audit Project of the Royal College of Anesthetists as well as the (DAS) Difficult Airway Society in the United Kingdom collected reports on major respiratory complications, where in almost 40% of patients, head and neck tumors and their complications related to airway management, and almost 75% of cases where an emergency surgical airway was required, therefore, when considering the airway approach in patients with head and neck tumors, we must know that there is currently a wide variety of devices that offer many possibilities for its management, remembering that the most important thing is not to have each and every one of them, but to establish and develop strategies and management plans, alternative options, in each patient, the possibility of predicting a difficult airway scenario and being able to anticipate events by preparing the equipment and personnel to make the right decisions.

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Utilidad del score predictivo de Cameron para la realización de traqueostomía electiva después de cirugía tumoral oral

Cited by 5 publications

References 14 publications

Evaluation of Scoring Systems for Airway Management After Oral Cancer Surgery: A Retrospective Study

Evaluation of Scoring Systems for Airway Management After Oral Cancer Surgery: A Retrospective Study

The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery

Consideraciones en la valoración de la vía aérea en el paciente con tumor de cabeza y cuello

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