Tsuru Seri, Wakimoto Mayuko, Iritakenishi Takeshi, Ogawa Makoto, Hayashi Yukio
Department of Anesthesiology, Osaka University Hospital, Osaka, Japan.
Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Hospital, Osaka, Japan.
Ann Card Anaesth. 2017 Jul-Sep;20(3):309-312. doi: 10.4103/aca.ACA_71_17.
Arytenoid cartilage dislocation/subluxation is one of the rare complications following tracheal intubation, and there have been no reports about risk factors leading this complication. From our clinical experience, we have an impression that patients undergoing cardiovascular operations tend to be associated with this complication.
We designed a large retrospective study to reveal the incidence and risk factors predicting the occurrence and to examine whether our impression is true.
This was a retrospective study.
We retrospectively studied 19,437 adult patients who were intubated by an anesthesiologist in our operation theater from 2002 to 2008. The tracheal intubation was performed by a resident anesthesiologist managing the patients. Only patients whose postoperative voice was disturbed more than 7 days were referred to the Department of Otorhinolaryngology-Head and Neck Surgery and examined using laryngostroboscopy by a laryngologist to diagnose arytenoid cartilage dislocation/subluxation. We evaluated age, sex, weight, height, duration of intubation, difficult intubation, and major cardiovascular operation as risk factors to lead this complication.
The data were analyzed by logistic regression analysis to assess factors for arytenoid cartilage dislocation/subluxation after univariate analyses using logistic regression analysis.
Our analysis indicated that difficult intubation (odds ratio: 12.1, P = 0.018) and cardiovascular operation (odds ratio: 9.9, P < 0.001) were significant risk factors of arytenoid cartilage dislocation/subluxation.
The present study demonstrated that major cardiovascular operation is one of the significant risk factors leading this complication.
杓状软骨脱位/半脱位是气管插管后罕见的并发症之一，目前尚无关于导致该并发症的危险因素的报道。根据我们的临床经验，我们感觉接受心血管手术的患者似乎更容易出现这种并发症。
我们设计了一项大型回顾性研究，以揭示其发生率和预测发生的危险因素，并检验我们的感觉是否正确。
这是一项回顾性研究。
我们回顾性研究了2002年至2008年在我们手术室由麻醉医生进行气管插管的19437例成年患者。气管插管由负责管理患者的住院麻醉医生进行。只有术后声音受干扰超过7天的患者才被转诊至耳鼻咽喉头颈外科，由耳鼻喉科医生使用频闪喉镜检查以诊断杓状软骨脱位/半脱位。我们评估了年龄、性别、体重、身高、插管持续时间、困难插管和重大心血管手术作为导致该并发症的危险因素。
在单因素分析后，使用逻辑回归分析对数据进行分析，以评估杓状软骨脱位/半脱位的相关因素。
我们的分析表明，困难插管（优势比：12.1，P = 0.018）和心血管手术（优势比：9.9，P < 0.001）是杓状软骨脱位/半脱位的显著危险因素。
本研究表明，重大心血管手术是导致该并发症的显著危险因素之一。
