TY - JOUR
T1 - Difficult laryngeal exposure in microlaryngoscopy
T2 - Can it be predicted preoperatively?
AU - Paul, Roshna Rose
AU - Varghese, Ajoy Mathew
AU - Mathew, John
AU - Chandrasekharan, Ramanathan
AU - Amalanathan, Sophia
AU - Asif, Syed Kamran
AU - Kurien, Mary
N1 - Publisher Copyright:
© Association of Otolaryngologists of India 2015.
PY - 2016/9/21
Y1 - 2016/9/21
N2 - The aim of the present study was to identify preoperative clinical predictors for difficult laryngeal exposure (DLE) and to define a simple grading system for laryngeal exposure. This is a prospective descriptive study carried out in a tertiary teaching hospital in South India. Patients above 18 years undergoing microlaryngoscopy had presurgical evaluation of 11 physical parameters. Grading of Modified Cormack-Lehane Score (MCLS) and rigid laryngoscopy were done during procedure. On logistic regression analysis, with a 95 % confidence interval (CI) MCLS was found to be a statistically significant predictor (odds ratio 12). With 90 % CI, neck circumference, atlanto-occipital extension and MCLS were significant (odds ratio of 4, 4, 12 respectively). Neck circumference of more than 34.25 cm and limited atlantooccipital extension of less than 19.50, predicts difficult laryngeal exposure. A simple grading system for laryngeal exposure during microlaryngoscopy is being proposed. MCLS grade more than 2a done intra operatively correlates well with difficult intubation.
AB - The aim of the present study was to identify preoperative clinical predictors for difficult laryngeal exposure (DLE) and to define a simple grading system for laryngeal exposure. This is a prospective descriptive study carried out in a tertiary teaching hospital in South India. Patients above 18 years undergoing microlaryngoscopy had presurgical evaluation of 11 physical parameters. Grading of Modified Cormack-Lehane Score (MCLS) and rigid laryngoscopy were done during procedure. On logistic regression analysis, with a 95 % confidence interval (CI) MCLS was found to be a statistically significant predictor (odds ratio 12). With 90 % CI, neck circumference, atlanto-occipital extension and MCLS were significant (odds ratio of 4, 4, 12 respectively). Neck circumference of more than 34.25 cm and limited atlantooccipital extension of less than 19.50, predicts difficult laryngeal exposure. A simple grading system for laryngeal exposure during microlaryngoscopy is being proposed. MCLS grade more than 2a done intra operatively correlates well with difficult intubation.
KW - Atlanto-occipital extension
KW - Difficult laryngeal exposure (DLE)
KW - Microlaryngoscopy
KW - Neck circumference
KW - Odds Ratio
KW - Pre-op clinical parameters
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U2 - 10.1007/s12070-015-0913-9
DO - 10.1007/s12070-015-0913-9
M3 - Article
AN - SCOPUS:84944706300
SN - 2231-3796
VL - 68
SP - 65
EP - 70
JO - Indian Journal of Otolaryngology and Head and Neck Surgery
JF - Indian Journal of Otolaryngology and Head and Neck Surgery
IS - 1
ER -