Grimes David, MacLeod Iain, Taylor Timothy, O'Connor Mary, Sidebottom Andrew
Queen's Medical Centre, Derby Road, Nottingham, UK, NG7 2UH.
Queen's Medical Centre, Derby Road, Nottingham, UK, NG7 2UH. Electronic address: Mary.O'
Br J Oral Maxillofac Surg. 2016 Jan;54(1):80-2. doi: 10.1016/j.bjoms.2015.09.034. Epub 2015 Nov 1.
Patients having oral and maxillofacial operations often require nasal intubation, but limited mouth opening and unfavourable nasal anatomy can make it difficult. We aimed to find out whether there is an association between the prediction of difficult nasal intubation on computed tomography (CT) and actual problems. We retrospectively reviewed the imaging and anaesthetic records of 77 patients who had replacement of the temporomandibular joint (TMJ) as these patients often have limited mouth opening and have had a preoperative CT. There was a positive correlation between a radiographically-assessed difficult nostril and difficulty of intubation (p<0.001). The positive predictive value was 71.4%. As a consequence, our radiologists now routinely report on the nasal cavity in these patients, and their report and the scan are then reviewed by the anaesthetist before intubation. Our results suggest that review of the CT before planned nasal intubation should be part of routine practice.
接受口腔颌面手术的患者通常需要进行鼻腔插管，但张口受限和鼻腔解剖结构不佳可能会使其变得困难。我们旨在探究计算机断层扫描（CT）对困难鼻腔插管的预测与实际问题之间是否存在关联。我们回顾性分析了77例颞下颌关节（TMJ）置换患者的影像学和麻醉记录，因为这些患者通常张口受限且术前行过CT检查。影像学评估的困难鼻孔与插管困难之间存在正相关（p<0.001）。阳性预测值为71.4%。因此，我们的放射科医生现在会常规报告这些患者的鼻腔情况，然后麻醉医生在插管前会查看他们的报告和扫描结果。我们的结果表明，在计划进行鼻腔插管前查看CT应成为常规操作的一部分。
