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International Bulletin of Otorhinolaryngology

Intraoperative and postoperative complications during microlaryngeal surgery

Ts. Marinov, M. Belitova, T. Popov, N. Nizamova, J. Rangachev, D. Popova

Abstract

Theoretical basis: Patients presenting for microlaryngeal surgery may have a variety of comorbidities contributing to their voice symptoms and affecting anesthetic management.
Results: Many patients presenting for laryngeal surgery have a long history of heavy smoking and drinking. Many patients who present for laryngeal surgery are elderly and have cardiovascular disease. The rate of difficult endotracheal intubation may reach almost 16% among patients presenting for ear, nose, or throat cancer surgery, which is on average six times higher than among the general surgical patient population. Loss of the airway on induction, requiring emergent cricothyrotomy or tracheostomy, can be sudden, especially in patients with critical airway obstruction. Prospective trials identify the incidence of dental trauma after suspension laryngoscopy at 0% to 6.5%, depending on the operator’s experience, methodology of the study, dental injury criteria, preexisting dentition status of the patient, and suspension technique used. Minor surgical complications, such as sore throat, mucosal injury (e.g., cuts, edema, hematoma), and cranial nerve dysfunction (e.g., lingual, glossopharyngeal, hypoglossal), are most commonly observed. The risk of postoperative airway compromise is significantly greater among the patients who underwent diagnostic laryngoscopy than those in the general surgical population.
Conclusion: Patients presenting for microlaryngeal surgery may have a variety of intraoperative and postoperative complications.

Keywords

Microlaryngeal surgery, intraoperative complications, postoperative complications

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References

Falcone MT, Garrett CG, Slaughter JC, Vaezi M: Transnasal esophagoscopy findings: Interspecialty comparison. Otolaryngol Head Neck Surg 140:812–815, 2009.

Rubin AD, Sataloff RT: Vocal fold paresis and paralysis. Otolaryngol Clin North Am 40:1109–1131, 2007.

Rees L, Mason RA: Advanced upper airway obstruction in ENT surgery. Br J Anaesth CEPD Rev 2:134–138, 2002.

Xiao P, Zhang XS: Adult laryngotracheal surgery. Anesthesiol Clin 28:529–540, 2010.

Lieber CS: Ethanol metabolism, cirrhosis and alcoholism. Clin Chim Acta 257:59–84, 1997.

McKillop IH, Schrum LW: Alcohol and liver cancer. Alcohol 35:195–203, 2005.

Sweeney BP, Bromilow J: Liver enzyme induction and inhibition: Implications for anaesthesia. Anaesthesia 61:159–177, 2006.

Sweeney BP, Grayling M: Smoking and anaesthesia: The pharmacological implications. Anaesthesia 64:179–186, 2009.

Ziser A, Plevak DJ, Wiesner RH, et al: Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology 90:42–53, 1999.

Arne J, Descoins P, Fusciardi J, et al: Preoperative assessment for difficult intubation in general and ENT surgery: Predictive value of a clinical multivariate risk index. Br J Anaesth 80:140–146, 1998.

Burkle CD, Walsh MT, Harrison BA, et al: Airway management after failure to intubate by direct laryngoscopy: Outcomes in a large teaching hospital. Can J Anaesth 52:634–640, 2005.

Rose DK, Cohen MM: The airway: Problems and predictions in 18,500 patients. Can J Anaesth 41:372–383, 1994.

Connelly NR, Ghandour K, Robbins L, et al: Management of unexpected difficult airway at a teaching institution over a 7-year period. J Clin Anesth 18:198–204, 2006.

Crosby ET, Cooper RM, Douglas MJ, et al: The unanticipated difficult airway with recommendations for management. Can J Anaesth 45:757–776, 1998.

Kheterpal S, Han R, Tremper KK, et al: Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology 105:885–891, 2006.

Kheterpal S, Martin L, Shanks AM, Tremper KK: Prediction and outcomes of impossible mask ventilation: A review of 50,000 anesthetics. Anesthesiology 110:891–897, 2009.

Bainton CR: Difficult intubation–what’s the best test? Can J Anaesth 43:541–543, 1996.

Tsao GJ, Damrose EJ: Complications of esophagoscopy in an academic training program. Otolaryngol Head Neck Surg 142:500–504, 2010.

Facciolongo N, Patelli M, Gasparini S, et al: Incidence of complica¬tions in bronchoscopy. Multicentre prospective study of 20, 986 bronchoscopies. Monaldi Arch Chest Dis 71:8–14, 2009.

Corvo MA, Inacio A, Mello MB, et al: Extra-laryngeal complica¬tions of suspension laryngoscopy. Braz J Otorhinolaryngol 73:727–732, 2007.

Robinson PM: Complications of microlaryngeal surgery. Clin Oto¬laryngol Allied Sci 14:545–549, 1989.

Jaquet Y, Monnier P, Van Melle G, et al: Complications of different ventilation strategies in endoscopic laryngeal surgery: A 10-year review. Anesthesiology 104:52–59, 2006.

Shikowitz MJ, Abramson AL, Liberatore L: Endolaryngeal jet ven¬tilation: A 10-year review. Laryngoscope 101:455–461, 1991.

Yung KC, Courey MS: The effect of office-based flexible endo¬scopic surgery on hemodynamic stability. Laryngoscope 120:2231–2236, 2010.

Theodore PR: Emergent management of malignancy-related acute airway obstruction. Emerg Med Clin North Am 27:231–241, 2009.

Rosen CA, Andrade Filho PA, Scheffel L, Buckmire R: Oropharyngeal complications of suspension laryngoscopy: A prospective study. Laryngoscope 115:1681–1684, 2005.

Benjamin B, Lindholm CE: Systematic direct laryngoscopy: The Lindholm laryngoscopes. Ann Otol Rhinol Laryngol 112(Pt 1):787–797, 2003.

Hill RS, Koltai PJ, Parnes SM: Airway complications from laryn¬goscopy and panendoscopy. Ann Otol Rhinol Laryngol 96:691–694, 1987.

Westreich R, Sampson I, Shaari CM, et al: Negative-pressure pulmonary edema after routine septorhinoplasty: Discussion of pathophysiology, treatment, and prevention. Arch Facial Plast Surg 8:8–15, 2006.

Chuang YC, Wang CH, Lin YS: Negative pressure pulmonary edema: Report of three cases and review of the literature. Eur Arch Otorhinolaryngol 264:1113–1116, 2007.

Mamiya H, Ichinohe T, Kaneko Y: Negative pressure pulmonary edema after oral and maxillofacial surgery. Anesth Prog 56:49–52, 2009.




DOI: http://dx.doi.org/10.14748/orl.v17i2.7980

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