Laryngeal injuries following endotracheal intubation in ENT surgery: predictive value of anatomical scores
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Laryngeal injuries following endotracheal intubation in ENT surgery: predictive value of anatomical scores. / Böttcher, Arne; Mencke, Thomas; Zitzmann, Amelie; Knecht, Rainald; Jowett, Nathan; Nöldge-Schomburg, Gabriele; Pau, Hans Wilhelm; Dommerich, Steffen.
in: EUR ARCH OTO-RHINO-L, Jahrgang 271, Nr. 2, 01.02.2014, S. 345-52.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Laryngeal injuries following endotracheal intubation in ENT surgery: predictive value of anatomical scores
AU - Böttcher, Arne
AU - Mencke, Thomas
AU - Zitzmann, Amelie
AU - Knecht, Rainald
AU - Jowett, Nathan
AU - Nöldge-Schomburg, Gabriele
AU - Pau, Hans Wilhelm
AU - Dommerich, Steffen
PY - 2014/2/1
Y1 - 2014/2/1
N2 - Endotracheal intubation has been associated with a threefold higher incidence of laryngopharyngeal complaints following anesthesia in comparison to laryngeal mask airway. Such complaints, including hoarseness and sore throat, have been reported in up to 90% of patients within 24 h of extubation. The purpose of this study was to determine which preoperatively documented clinical and anatomic parameters are predictive of laryngo-pharyngeal trauma resulting from elective endotracheal intubation. Fifty-three patients undergoing ENT procedures requiring general anesthesia with endotracheal intubation were recruited. Pre and postoperative laryngostroboscopic examination was performed and findings correlated to preoperative clinical and anatomic parameters. Readily assessed anatomic parameters including height (>180 cm) and weight (>80 kg) correlated significantly to the Eckerbom grade of intubation-associated acute laryngeal injury (rs = 0.374; p = 0.006 and rs = 0.278; p = 0.044, respectively). The mandibular protrusion test also correlated significantly to the Eckerbom grade (rs = 0.462, p = 0.001) while the upper-lip-bite test showed significant correlation to impaired vocal fold oscillation (rs = 0.288, p = 0.036), with injury prediction sensitivities of 37.5 and 39.4%, respectively. No parameters correlated to subjective complaints (n = 5, 9.2%). This study provides suggestions on how to improve the classification of intubation-associated laryngeal injuries as well as providing the basis for larger clinical trials in other surgical subspecialties.
AB - Endotracheal intubation has been associated with a threefold higher incidence of laryngopharyngeal complaints following anesthesia in comparison to laryngeal mask airway. Such complaints, including hoarseness and sore throat, have been reported in up to 90% of patients within 24 h of extubation. The purpose of this study was to determine which preoperatively documented clinical and anatomic parameters are predictive of laryngo-pharyngeal trauma resulting from elective endotracheal intubation. Fifty-three patients undergoing ENT procedures requiring general anesthesia with endotracheal intubation were recruited. Pre and postoperative laryngostroboscopic examination was performed and findings correlated to preoperative clinical and anatomic parameters. Readily assessed anatomic parameters including height (>180 cm) and weight (>80 kg) correlated significantly to the Eckerbom grade of intubation-associated acute laryngeal injury (rs = 0.374; p = 0.006 and rs = 0.278; p = 0.044, respectively). The mandibular protrusion test also correlated significantly to the Eckerbom grade (rs = 0.462, p = 0.001) while the upper-lip-bite test showed significant correlation to impaired vocal fold oscillation (rs = 0.288, p = 0.036), with injury prediction sensitivities of 37.5 and 39.4%, respectively. No parameters correlated to subjective complaints (n = 5, 9.2%). This study provides suggestions on how to improve the classification of intubation-associated laryngeal injuries as well as providing the basis for larger clinical trials in other surgical subspecialties.
KW - Adolescent
KW - Adult
KW - Aged
KW - Anesthesia, General
KW - Female
KW - Hoarseness
KW - Humans
KW - Intubation, Intratracheal
KW - Larynx
KW - Male
KW - Middle Aged
KW - Otorhinolaryngologic Surgical Procedures
KW - Pharyngitis
KW - Pharynx
KW - Preoperative Care
KW - Stroboscopy
KW - Young Adult
U2 - 10.1007/s00405-013-2659-x
DO - 10.1007/s00405-013-2659-x
M3 - SCORING: Journal article
C2 - 23990031
VL - 271
SP - 345
EP - 352
JO - EUR ARCH OTO-RHINO-L
JF - EUR ARCH OTO-RHINO-L
SN - 0937-4477
IS - 2
ER -