Greer Devon, Marshall Kathryn E, Bevans Scott, Standlee Aurora, McAdams Patricia, Harsha Wayne
Department of Otolaryngology, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, U.S.A.
Laryngoscope. 2017 Feb;127(2):349-353. doi: 10.1002/lary.26134. Epub 2016 Jun 27.
Reports of patient injuries associated with videolaryngoscopy are increasing in the literature. There are a wide variety of opinions regarding both safe use of the device and patient care following aerodigestive tract injury. We have seen an increase in videolaryngoscopy-associated injuries in recent years at our institution. Because of this, we wanted to determine if video-assisted laryngoscopy presents a greater risk of injury compared with direct laryngoscopy. Furthermore, we wanted to determine if there were patient and/or surgical factors that could contribute to patient injuries following videolaryngoscopy.
MAMC anesthesia records, PubMed, Ovid.
We compared rates of injury between videolaryngoscopy to direct laryngoscopy at our institution by searching anesthesia records to identify laryngoscopy procedures that resulted in injury to the soft palate or oropharynx. We also identified 19 published cases in the literature, in addition to our cases, that we reviewed for patient characteristics (e.g., body mass index, age and sex, Mallampati grade), type of videolaryngoscope, location of injury, and type of repair (if any) required.
At our institution, we have a statistically higher rate of injury using videolaryngoscopy compared to direct laryngoscopy. Our data also indicate that women are more commonly injured during videolaryngoscope intubation than men. The right tonsillar pillars and soft palate are the most frequently injured, with through-and-through perforation of the soft tissues being the most common type of injury. The most common repair of injuries required simple closures, and long-term harm was very rare.
Our data suggests that using video-assisted laryngoscopy for intubation puts a patient at significantly greater risk for injury compared to direct laryngoscopy. Laryngoscope, 2016 127:349-353, 2017.
文献中与视频喉镜检查相关的患者损伤报告日益增多。关于该设备的安全使用以及气道消化道损伤后的患者护理，存在各种各样的观点。近年来，我院与视频喉镜检查相关的损伤有所增加。因此，我们想确定与直接喉镜检查相比，视频辅助喉镜检查是否会带来更大的损伤风险。此外，我们想确定是否存在可能导致视频喉镜检查后患者受伤的患者和/或手术因素。
MAMC麻醉记录、PubMed、Ovid。
我们通过查阅麻醉记录来比较我院视频喉镜检查与直接喉镜检查的损伤发生率，以确定导致软腭或口咽损伤的喉镜检查操作。除了我们的病例外，我们还在文献中找到了19例已发表的病例，并对其进行了回顾，分析患者特征（如体重指数、年龄和性别、马兰帕蒂分级）、视频喉镜类型、损伤部位以及所需的修复类型（如有）。
在我院，与直接喉镜检查相比，视频喉镜检查导致损伤的发生率在统计学上更高。我们的数据还表明，女性在视频喉镜插管过程中比男性更容易受伤。右侧扁桃体柱和软腭是最常受伤的部位，软组织贯通穿孔是最常见的损伤类型。损伤最常见的修复方式是简单缝合，长期伤害非常罕见。
我们的数据表明，与直接喉镜检查相比，使用视频辅助喉镜检查进行插管会使患者面临更大的受伤风险。《喉镜》，2016年127卷：349 - 353页，2017年。
