Department of Otolaryngology - Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), France.
Department of Otolaryngology - Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), France.
Am J Otolaryngol. 2022 Sep-Oct;43(5):103605. doi: 10.1016/j.amjoto.2022.103605. Epub 2022 Aug 11.
Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) presents obvious advantage in laryngeal surgery and Transoral Laser Microsurgery (TLM). Airway fire represents a rare complication of TLM and may be the most important limitation in the use of THRIVE. The objective was to evaluate the different operating conditions of the TLM with THRIVE with regard to fire risk.
In this report, we assessed the risk of fire by varying the Fraction of Inspired Oxygen (FiO2), the Laser Energy, and the placement of endolaryngeal surgical and ventilatory equipment in a porcine model for TLM.
Fire, sparks and smoke were reported. No combustion occurred with THRIVE in the absence of an endolaryngeal material. Fire occurred systematically while delivering between 3 and 5 W Carbon dioxide (CO2) Laser direct shot on a dry laryngeal cotton. Conclusion THRIVE-TLM should never be performed using a dry cotton or a plastic endolaryngeal material.
经鼻湿化快速交换通气（THRIVE）在喉科手术和经口激光显微手术（TLM）中具有明显优势。气道着火是 TLM 的一种罕见并发症，可能是 THRIVE 使用的最重要限制因素。目的是评估 TLM 与 THRIVE 联合使用时的不同手术条件与火灾风险的关系。
在本报告中，我们通过改变吸入氧气分数（FiO2）、激光能量以及在内镜手术和通气设备在猪模型中的位置来评估火灾风险。
报告了火灾、火花和烟雾。在内镜无材料的情况下，THRIVE 没有发生燃烧。当直接喷射 3 至 5 瓦特二氧化碳（CO2）激光时，干燥的喉部棉会引发火灾。结论 THRIVE-TLM 绝对不能在内镜有干棉或塑料材料的情况下使用。
