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喉力传感器:悬雍垂微创喉镜术后评估喉外并发症的量化指标

Laryngeal Force Sensor: Quantifying Extralaryngeal Complications after Suspension Microlaryngoscopy.

机构信息

1 Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.

2 Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.

出版信息

Otolaryngol Head Neck Surg. 2018 Aug;159(2):328-334. doi: 10.1177/0194599818768482. Epub 2018 Apr 3.

Abstract

Objectives To develop a novel sensor capable of dynamically analyzing the force exerted during suspension microlaryngoscopy and to examine the relationship between force and postoperative tongue complications. Study Design Prospective observational study. Setting Academic tertiary care center. Methods The laryngeal force sensor is a designed for use during microphonosurgery. Prospectively enrolled patients completed pre- and postoperative surveys to assess the development of tongue-related symptoms (dysgeusia, pain, paresthesia, and paresis) or dysphagia (10-item Eating Assessment Tool [EAT-10]). To prevent operator bias, surgeons were blinded to the force recordings during surgery. Results Fifty-six patients completed the study. Of these, 20 (36%) developed postoperative tongue symptoms, and 12 (21%) had abnormal EAT-10 scores. The mean maximum force across all procedures was 164.7 N (95% CI, 141.0-188.4; range, 48.5-402.6), while the mean suspension time was 34.3 minutes (95% CI, 27.4-41.2; range, 7.1-108.1). Multiple logistic regression showed maximum force (odds ratio, 1.15; 95% CI, 1.02-1.29; P = .019) and female sex (30.1%; 95% CI, 22.7%-37.5%; P < .001) as significant predictors for the development of tongue-related symptoms. The only significant predictor of an abnormal postoperative EAT-10 score was an increased maximum force (odds ratio, 1.03; 95% CI, 1.00-1.06; P = .045). Conclusions The laryngeal force sensor is capable of providing dynamic force measurements throughout suspension microlaryngoscopy. An increase in maximum force during surgery may be a significant predictor for the development of tongue-related symptoms and an abnormal EAT-10 score. Female patients may also be at greater risk for developing postoperative tongue symptoms.

摘要

目的 开发一种新型传感器,能够动态分析悬雍垂显微喉镜检查中施加的力,并研究力与术后舌并发症之间的关系。

研究设计 前瞻性观察性研究。

设置 学术三级护理中心。

方法 喉力传感器专为显微嗓音手术设计。前瞻性入组的患者在术前和术后完成调查,以评估与舌相关的症状(味觉障碍、疼痛、感觉异常和瘫痪)或吞咽困难(10 项饮食评估工具 [EAT-10])的发展情况。为了防止操作者的偏见,手术过程中外科医生对力记录是盲法的。

结果 56 名患者完成了研究。其中,20 名(36%)患者术后出现舌部症状,12 名(21%)患者 EAT-10 评分异常。所有手术的平均最大力为 164.7 N(95%置信区间,141.0-188.4;范围,48.5-402.6),而平均悬停时间为 34.3 分钟(95%置信区间,27.4-41.2;范围,7.1-108.1)。多因素逻辑回归显示最大力(优势比,1.15;95%置信区间,1.02-1.29;P =.019)和女性(30.1%;95%置信区间,22.7%-37.5%;P <.001)是舌相关症状发生的显著预测因素。术后 EAT-10 评分异常的唯一显著预测因素是最大力增加(优势比,1.03;95%置信区间,1.00-1.06;P =.045)。

结论 喉力传感器能够在悬雍垂显微喉镜检查过程中提供动态力测量。手术过程中最大力的增加可能是与舌相关症状和 EAT-10 评分异常发展的重要预测因素。女性患者发生术后舌部症状的风险也可能更高。

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