Li J J, Chen W X, Zhu Z F, Zhang J L, He F Y, Wang Y J
Department of Otolaryngology Head and Neck Surgery, the First People's Hospital of Foshan, Foshan,528000,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Apr 5;31(7):520-523. doi: 10.13201/j.issn.1001-1781.2017.07.007.
The aim of this study was to demonstrate the risk factors which affect the exposure of glottis in suspension laryngoscopy.We performed a prospective study about 90 cases of vocal cord lesions underwent microlaryngosurgery(including polyps,vocal nodules,cyst and papilloma).Then we recorded the clinical data related to glottic exposure, both preoperatively and intraoperatively. Univariate analysis showed that parameters like age(=0.038), Cormack-Lehane score(=0.007),maximuminterincisors gap(=0.007),hyoid-mental distance(HMD) in full extension(=0.033), thyroid-mental distance(TMD) in full extension(=0.014), vertical thyroid-mental distance(VTMD) in full extension(=0.042), sternum-mental distance(SMD) in full extension(=0.01) and degree of neck flexion-extension(=0.003) were related to intraoperative difficult exposure of the glottic area.In logistic regression analysis, Cormack-Lehane score(=0.003), maximuminterincisors gap(=0.001) and degree of neck flexion-extension(=0.002) were significantly risk factors of difficult laryngealexposure. Combination of Cormack-Lehane score, maximuminterincisors gap and degree of neck flexion-extensionmay help to predict the difficult laryngealexposure, so we should evaluate patients before operations of suspension laryngoscopy to decrease the surgical complication.
本研究的目的是阐明影响支撑喉镜检查中声门暴露的危险因素。我们对90例行显微喉镜手术（包括息肉、声带小结、囊肿和乳头状瘤）的声带病变患者进行了一项前瞻性研究。然后我们记录了术前和术中与声门暴露相关的临床数据。单因素分析显示，年龄（=0.038）、Cormack-Lehane分级（=0.007）、最大门齿间距（=0.007）、完全伸展时舌骨-颏下距离（HMD）（=0.033）、完全伸展时甲状软骨-颏下距离（TMD）（=0.014）、完全伸展时垂直甲状软骨-颏下距离（VTMD）（=0.042）、完全伸展时胸骨-颏下距离（SMD）（=0.01）和颈部屈伸程度（=0.003）等参数与术中声门区暴露困难有关。在逻辑回归分析中，Cormack-Lehane分级（=0.003）、最大门齿间距（=0.001）和颈部屈伸程度（=0.002）是喉镜暴露困难的显著危险因素。Cormack-Lehane分级、最大门齿间距和颈部屈伸程度的联合应用可能有助于预测喉镜暴露困难，因此我们应在支撑喉镜手术前对患者进行评估，以降低手术并发症。
