Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, 3440 N. Broad St, Philadelphia, PA 19140, USA.
Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, 3440 N. Broad St, Philadelphia, PA 19140, USA.
Am J Otolaryngol. 2020 May-Jun;41(3):102402. doi: 10.1016/j.amjoto.2020.102402. Epub 2020 Jan 17.
Suspension laryngoscopy is a commonly performed procedure in otolaryngology. During the procedure, the laryngoscope applies direct force to the tongue. Postoperative tongue symptoms include pain, swelling, numbness, taste disturbance, and rarely motor deficits. Duration and magnitude of force applied have previously been associated with post-operative throat and tongue pain, respectively. We sought to correlate postoperative tongue symptoms with magnitude of force applied and/or duration of suspension and investigate any risk factors for tongue morbidity.
A sample of patients undergoing suspension laryngoscopy between 2015 and 2018 were prospectively recruited. Those with preexisting tongue symptoms, disease or surgery were excluded. Patients completed preoperative and postoperative questionnaires evaluating tongue swelling, numbness, motion and taste disturbance. Symptoms were subjectively scored on a visual scale from 0 to 10. Patient demographics, past medical and social history were also recorded. Intraoperative pressures were measured using a spring force scale, positioned between the suspension arm and Mayo stand. Initial and end suspension forces and duration of suspension were recorded.
120 patients met inclusion criteria, of which 63 completed both preoperative and postoperative questionnaires. 6 patients (9.5%) experienced postoperative tongue symptoms. Suspension force and duration of suspension were not significantly predictive of postoperative tongue symptoms. While all symptomatic patients were current or former cigarette smokers, smoking status was not found to be a statistically significant factor.
Neither suspension forces nor duration of suspension were predictive of postoperative tongue morbidity. Further research is needed to evaluate the role of smoking status on postoperative tongue symptoms.
悬雍垂切除术是耳鼻喉科常见的手术。在手术过程中，喉镜直接向舌头施加力。术后舌头症状包括疼痛、肿胀、麻木、味觉障碍，极少数出现运动功能障碍。之前的研究已经证实，施加的力的持续时间和大小分别与术后喉咙和舌头疼痛有关。我们旨在通过测量施加的力的大小和/或悬雍垂的持续时间来评估术后舌头症状，并探讨与舌头发病率相关的任何危险因素。
本研究前瞻性地招募了 2015 年至 2018 年间接受悬雍垂切除术的患者。排除了术前有舌头症状、疾病或手术的患者。患者在术前和术后均完成了评估舌头肿胀、麻木、运动和味觉障碍的问卷。症状通过视觉量表进行主观评分，范围为 0 至 10 分。同时还记录了患者的人口统计学资料、既往医疗和社会史。术中压力通过位于悬雍垂臂和 Mayo 架之间的弹簧力计进行测量。记录初始和结束时的悬雍垂力以及悬雍垂的持续时间。
共有 120 名患者符合纳入标准，其中 63 名患者完成了术前和术后的问卷。6 名患者（9.5%）出现术后舌头症状。悬雍垂力和悬雍垂持续时间与术后舌头症状无显著相关性。虽然所有有症状的患者均为现吸烟者或既往吸烟者，但吸烟状态并未被发现是一个统计学上显著的因素。
悬雍垂力和悬雍垂持续时间均不能预测术后舌头发病率。需要进一步研究吸烟状态对术后舌头症状的作用。
