视频喉镜在头颈部外科诊断和治疗干预中的应用。
Utility of videolaryngoscopy for diagnostic and therapeutic interventions in head and neck surgery.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Stanford, CA 94304, USA.
Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA.
出版信息
Am J Otolaryngol. 2020 Jul-Aug;41(4):102284. doi: 10.1016/j.amjoto.2019.102284. Epub 2019 Sep 4.
BACKGROUND
Videolaryngoscopy is commonly used by anesthesiologists to manage difficult airways. Recently otolaryngologists have reported use in select procedures; to date there is limited evaluation in head and neck surgery.
MATERIALS AND METHODS
Patients who underwent direct laryngoscopy (DL) with use of GlideScope videolaryngoscopy (GVL) were retrospectively identified from a tertiary care Veterans Affairs hospital. GVL was used to assist or replace traditional laryngoscopes for diagnostic and therapeutic procedures.
RESULTS
Nineteen patients (48-83 years old) underwent 21 procedures. Difficult endotracheal intubation was reported in 53% of patients. GVL replaced traditional DL in 76% of cases, assisted evaluation prior to traditional DL in 10%, and rescued failed traditional DL in 14%. No complications occurred. Three indications for GVL were identified.
DISCUSSION
GVL was safe in our experience and provides unique benefits in selected scenarios in head and neck surgery. Otolaryngologists can consider videolaryngoscopy as a complement to traditional DL.
背景
视频喉镜被麻醉医师广泛用于处理困难气道。最近耳鼻喉科医生也在一些特定的手术中报告了其应用；但迄今为止，在头颈部手术中的评估有限。
材料和方法
我们从一家三级保健退伍军人事务医院的病历中回顾性地确定了使用 GlideScope 视频喉镜（GVL）进行直接喉镜（DL）的患者。GVL 用于辅助或替代传统喉镜进行诊断和治疗程序。
结果
19 名患者（48-83 岁）接受了 21 次手术。53%的患者报告存在困难气管插管。GVL 替代了 76%的传统 DL，在 10%的病例中辅助了传统 DL 前的评估，在 14%的病例中挽救了传统 DL 失败的情况。未发生并发症。确定了 GVL 的三个适应证。
讨论
在我们的经验中，GVL 是安全的，在头颈部手术的某些特定情况下提供了独特的优势。耳鼻喉科医生可以考虑将视频喉镜作为传统 DL 的补充。
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