Kok Saskia E, Lemson Joris, van den Hoogen Frank J A
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Department of Paediatric Critical Care, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
J Clin Med. 2023 Feb 12;12(4):1473. doi: 10.3390/jcm12041473.
The aim of this study was to evaluate our institutions airway management and complications after submandibular duct relocation (SMDR). We analysed a historic cohort of children and adolescents who were examined at the Multidisciplinary Saliva Control Centre between March 2005 and April 2016. Ninety-six patients underwent SMDR for excessive drooling. We studied details of the surgical procedure, postoperative swelling and other complications. Ninety-six patients, 62 males and 34 females, were treated consecutively by SMDR. Mean age at time of surgery was 14 years and 11 months. The ASA physical status was 2 in most patients. The majority of children were diagnosed with cerebral palsy (67.7%). Postoperative swelling of the floor of the mouth or tongue was reported in 31 patients (32.3%). The swelling was mild and transient in 22 patients (22.9%) but profound swelling was seen in nine patients (9.4%). In 4.2% of the patients the airway was compromised. In general, SMDR is a well-tolerated procedure, but we should be aware of swelling of the tongue and floor of the mouth. This may lead to a prolonged period of endotracheal intubation or a need for reintubation which can be challenging. After extensive intra-oral surgery such as SMDR we strongly recommend a extended perioperative intubation and extubation after the airway is checked and secure.
本研究的目的是评估我院在进行下颌下腺导管重新定位术（SMDR）后的气道管理及并发症情况。我们分析了一个历史性队列，该队列中的儿童和青少年于2005年3月至2016年4月期间在多学科唾液控制中心接受检查。96例患者因流涎过多接受了SMDR手术。我们研究了手术过程细节、术后肿胀及其他并发症情况。96例患者，其中62例男性和34例女性，连续接受了SMDR治疗。手术时的平均年龄为14岁11个月。大多数患者的美国麻醉医师协会（ASA）身体状况分级为2级。大多数儿童被诊断为脑瘫（67.7%）。31例患者（32.3%）报告有口底或舌部术后肿胀。22例患者（22.9%）的肿胀为轻度且短暂，但9例患者（9.4%）出现了严重肿胀。4.2%的患者气道受到影响。总体而言，SMDR是一种耐受性良好的手术，但我们应注意舌部和口底的肿胀。这可能导致气管插管时间延长或需要再次插管，这可能具有挑战性。在进行如SMDR这样的广泛口腔内手术后，我们强烈建议在检查气道并确保安全后延长围手术期的插管和拔管时间。
