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Prediction of difficulty in direct laryngoscopy
Ines Kharrat1,2, Imen Achour1,2, Jihene Jdidi Trabelsi3,2
1Department of Otorhinolaryngology, Habib Bourguiba Hospital, Sfax, Tunisia.
Scientific Reports
|June 24, 2022
Summary
Predicting difficult laryngeal exposure (DLE) in direct laryngoscopy is crucial. Maxilla length and atlanto-occipital distance are key preoperative predictors for DLE, aiding surgical planning.
Area of Science:
- Otolaryngology
- Anesthesiology
- Surgical Planning
Background:
- Direct laryngoscopy is essential for laryngeal procedures.
- Predicting difficult laryngeal exposure (DLE) can improve patient safety and surgical outcomes.
- Current methods for predicting DLE have limitations.
Purpose of the Study:
- To identify easily measurable and reproducible preoperative parameters for predicting difficult laryngeal exposure (DLE) during direct laryngoscopy.
- To evaluate the association between various physical and radiological measurements and DLE.
Main Methods:
- A prospective study of 71 patients undergoing transoral microsurgery for laryngeal lesions.
- Assessment included Mallampati score, body mass index, cervical measurements, and cervical radiography.
- Statistical analysis, including stepwise logistic regression, was used to identify predictors of DLE.
Main Results:
- High Mallampati and Cormack scores were significantly associated with DLE.
- Limited mouth opening, specific thyromental and sternomental distances, and cervical radiography parameters were related to DLE.
- Effective maxilla length and atlanto-occipital distance were identified as independent predictors of DLE (p=0.015 and p=0.001, respectively).
Conclusions:
- Preoperative prediction of DLE is valuable for surgeons and patients.
- Effective maxilla length and atlanto-occipital distance are independent risk factors for DLE.
- Maxillary overgrowth, dental protrusion, and limited cervical spine extension contribute to DLE.
