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一致的技术可限制支撑喉镜检查的并发症。

Consistent Technique Limits Suspension Laryngoscopy Complications.

作者信息

Larner Sean P, Fornelli Rick A, Griffith Shane D

机构信息

Department of Otolaryngology, University of Pittsburgh Medical Center Hamot, Erie, PA, United States.

Department of Otolaryngology, West Virginia University School of Medicine, Morgantown, WV, United States.

出版信息

Int Arch Otorhinolaryngol. 2019 Jul;23(3):e305-e310. doi: 10.1055/s-0039-1684036. Epub 2019 May 28.

Abstract

Suspension laryngoscopy (SL) is a commonly performed procedure among otolaryngologists. Several studies have shown that adverse effects occur regularly with SL.  To evaluate the postoperative complications of SL, and to determine if protecting the dentition and the oral mucosa and limiting suspension times decrease the overall incidence of oral cavity and pharyngeal complications of SL.  All of the cases of SL performed by 1 surgeon from November 2008 through September 2014 were retrospectively reviewed. A consistent technique for dental and mucosal protection was utilized, and suspension times were strictly limited to 30 consecutive minutes. The incidence of postoperative complications was calculated and analyzed with respect to gender, smoking status, dentition, laryngoscope type, and suspension system.  A total of 213 consecutive SL cases were reviewed, including 174 patients (94 male, 80 female). The overall postoperative complication rate was of 3.8%. Four patients experienced tongue-related complications, two experienced oral mucosal alterations, one had a dental injury, and one experienced a minor facial burn. The complication incidence was greater with the Zeitels system (12.5%) compared with the Lewy suspension system (3.3%), although it was not significant (  = 0.4). Likewise, the association of complications with other patient factors was not statistically significant.  Only 8 out of 213 cases in the present series experienced complications, which is significantly less than the complication rates observed in other reports. Consistent and conscientious protection of the dentition and of the oral mucosa and limiting suspension times to 30 minutes are factors unique to our series that appear to reduce complications in endolaryngeal surgery.

摘要

悬吊喉镜检查(SL)是耳鼻喉科医生常做的一项操作。多项研究表明,SL经常会出现不良反应。为了评估SL术后并发症,并确定保护牙列和口腔黏膜以及限制悬吊时间是否会降低SL口腔和咽部并发症的总体发生率。回顾性分析了2008年11月至2014年9月期间由1名外科医生实施的所有SL病例。采用了一致的牙齿和黏膜保护技术,悬吊时间严格限制为连续30分钟。计算并分析了术后并发症的发生率与性别、吸烟状况、牙列、喉镜类型和悬吊系统的关系。共回顾了213例连续的SL病例,包括174例患者(94例男性,80例女性)。术后总体并发症发生率为3.8%。4例患者出现与舌头相关的并发症,2例出现口腔黏膜改变,1例有牙齿损伤,1例出现轻微面部烧伤。与Lewy悬吊系统(3.3%)相比,Zeitels系统的并发症发生率更高(12.5%),尽管差异无统计学意义(P = 0.4)。同样,并发症与其他患者因素之间的关联也无统计学意义。本系列213例病例中只有8例出现并发症,明显低于其他报告中观察到的并发症发生率。对牙列和口腔黏膜进行持续、认真的保护以及将悬吊时间限制在30分钟是本系列特有的因素,似乎可减少喉内手术中的并发症。

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