| Prediction of difficult laryngeal exposure in patients undergoing microlaryngosurgery. | |
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MedLine Citation:
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PMID: 16190094 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Although difficult laryngeal exposure (DLE) is a common problem encountered during microlaryngosurgery, reliable predictors of DLE and grading systems of laryngeal exposure have been scarcely suggested in the field of laryngology. We propose a new classification of laryngeal exposure focusing on the extent of glottic visualization. METHODS: We investigated physical parameters that could predict DLE; 73 patients underwent a physical examination including 15 parameters. During endotracheal intubation and suspension laryngoscopy, Cormack-Lehane and laryngeal exposure scores were obtained for each patient and compared with the parameters. RESULTS: The patients' ages ranged from 23 to 77 years. The laryngeal exposure score was correlated with the Cormack-Lehane score (p < .001, r = 0.469). Of all parameters, body mass index, neck circumference, thyroid-mental distance, and horizontal thyroid-mental distance showed significant correlation with the laryngeal exposure score (p < .05). From analysis of the candidate parameters in 13 patients with DLE and the non-DLE group, we found that the cutoff values for predicting DLE were a body mass index of > 25.0 kg/m2, a neck circumference of > 39.5 cm, a thyroid-mental distance of < 5.5 cm, and a horizontal thyroid-mental distance of < 4.0 cm. CONCLUSIONS: According to the proposed classification of laryngeal exposure, patients with obesity, a muscular neck, or retrognathia are likely to present DLE, and preoperative measurement of the predictors may be useful in preparing for microlaryngosurgery. |
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Authors:
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Jong-Lyel Roh; Yong-Won Lee |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of otology, rhinology, and laryngology Volume: 114 ISSN: 0003-4894 ISO Abbreviation: Ann. Otol. Rhinol. Laryngol. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-09-29 Completed Date: 2005-10-20 Revised Date: 2006-05-15 |
Medline Journal Info:
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Nlm Unique ID: 0407300 Medline TA: Ann Otol Rhinol Laryngol Country: United States |
Other Details:
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Languages: eng Pagination: 614-20 Citation Subset: AIM; IM |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Chungnam National University College of Medicine, Daejeon, South Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Humans Intubation, Intratracheal Laryngeal Diseases / complications, pathology, surgery* Laryngoscopy* Larynx / surgery* Male Microsurgery* Middle Aged Neck Muscles / pathology Obesity / complications Pharyngeal Diseases / complications, pathology, surgery Predictive Value of Tests Retrognathism / complications |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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