[Success rate and complications of a modified retrograde intubation technic in 36 patients]

The main disadvantage of guided blind intubation (Waters technique) is injury to the mucous membrane and cartilaginous skeleton of the larynx. Thirty-six patients scheduled for laryngectomy were intubated using a modified Waters technique. The practicability of this technique as well as the type and extent of damage to the laryngeal tissue were evaluated under controlled conditions. Intubation was successful in 35 patients (first attempt, 31 patients; 2-3 attempts, four patients). A stenosing carcinoma of the larynx required a tracheotomy in the remaining patient. No serious damage to the mucous membrane or cartilage was demonstrated in the 26 controlled resected larynges. In a difficult intubation, the guided blind technique is a possible alternative because of the relatively low extent of damage and technical requirements; maintenance of spontaneous respiration is not required.