Wa Y L, Xu X L, Zhou L, Wang R Q, Zhuang P Y
Department of Otorhinolaryngology,Zhongshan Hospital,Xiamen University,Xiamen,361004,China.
Medical College of Xiamen University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jul 5;30(13):1042-1046. doi: 10.13201/j.issn.1001-1781.2016.13.009.
This paper seeks to identify useful and reliable indicators for predicting the occurrence of difficult laryngeal exposure(DLE) in microlaryngosurgery.Sixty-two patients were given physical examinations,including 4 general parameters:age,sex,BMI,and MMI,and 14 physical measurement parameters(TA,UIA,LIA,IG,LIMD,MA,MCD,MH,MDI,HMD,TMD,SMD,TMA,THUIA).Univariate analysis,stepwise regression analysis and ROC curve analysis were employed to identify parameters with the potential to predict DLE.We found sex(<0.05) showed significant correlation with the laryngeal exposure score(<0.05).We also found LIMD,MA,TMA and THUIA to be reliable DLE predictors.The cutoff values for predicting DLE were LIMD>4.53cm,MA>115.5°,TMA>99.2°,and THUIA>152.6°.X-ray measurement predictors of LIMD,MA,TMA,and THUIA before operation are important for the prediction of DLE.Sex is also the reliable DLE predictor.Males were prone to DLE.
本文旨在确定用于预测显微喉镜手术中困难喉镜暴露（DLE）发生的有用且可靠的指标。对62例患者进行了体格检查，包括4项一般参数：年龄、性别、体重指数（BMI）和甲颏间距（MMI），以及14项体格测量参数（甲状软骨厚度、甲状软骨上切迹至舌骨间距、甲状软骨上切迹至环状软骨间距、舌骨至甲状软骨切迹间距、舌骨至甲状软骨膜间距、甲状软骨膜至甲状软骨切迹间距、甲状软骨膜至环状软骨间距、甲状软骨膜至舌骨间距、甲状软骨膜至环状软骨弓间距、甲状软骨膜至舌骨大角间距、甲状软骨膜至甲状软骨上角间距、甲状软骨膜至甲状软骨下角间距、甲状软骨膜至甲状软骨切迹水平甲状软骨厚度、甲状软骨上切迹至舌骨大角间距）。采用单因素分析、逐步回归分析和ROC曲线分析来确定具有预测DLE潜力的参数。我们发现性别（<0.05）与喉镜暴露评分（<0.05）显示出显著相关性。我们还发现舌骨至甲状软骨膜间距、甲状软骨膜至甲状软骨切迹间距、甲状软骨膜至甲状软骨上角间距和甲状软骨上切迹至舌骨大角间距是可靠的DLE预测指标。预测DLE的临界值为舌骨至甲状软骨膜间距>4.53cm、甲状软骨膜至甲状软骨切迹间距>115.5°、甲状软骨膜至甲状软骨上角间距>99.2°和甲状软骨上切迹至舌骨大角间距>152.6°。术前舌骨至甲状软骨膜间距、甲状软骨膜至甲状软骨切迹间距、甲状软骨膜至甲状软骨上角间距和甲状软骨上切迹至舌骨大角间距的X线测量预测指标对DLE的预测很重要。性别也是可靠的DLE预测指标。男性更容易发生DLE。
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