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Transoral Laser Microlaryngeal Surgery with MLT Tubes: A Retrospective Case Series
Umme Sarah1, Dinesh Raju2, Shehzad Parveen2
1Fellow in Oncoanaesthesia & Perioperative Medicine, Department of Anaesthesiology, Critical Care and Pain- Cytecare Cancer Hospitals, Bengaluru, India.
Summary
Multilaser tubes (MLT) offer effective visualization and ventilation for transoral laser microsurgery (MLS), with a low complication rate. While laser-resistant tubes are preferred, MLT tubes are a viable alternative when used cautiously.
Area of Science:
- Otolaryngology
- Surgical Technology
Background:
- Transoral laser microsurgery (MLS) requires specialized equipment for airway management.
- Laser-resistant endotracheal tubes are the gold standard but may have limited availability.
Purpose of the Study:
- To evaluate the effectiveness and safety of using standard Multilaser tubes (MLT) for transoral laser MLS.
- To assess surgical visualization, lesion excision, oxygenation, ventilation, and airway complications during MLS with MLT.
Main Methods:
- A retrospective case series of 64 patients undergoing transoral laser MLS over 18 months.
- Review of electronic medical records for vital parameters, ventilation, ET tube details, surgical field, and adverse events.
Main Results:
- Size 5 MLT tubes were used in 82.8% of cases.
- Good surgical field exposure (92.2%) and adequate oxygenation (average FiO2 0.29) were achieved.
- High on-table extubation rate (98.4%) with low incidence of cuff rupture (4.7%) and bronchospasm (1.6%).
Conclusions:
- MLT tubes can be a safe and effective alternative for transoral laser MLS when laser-resistant tubes are unavailable.
- Adequate precautions are necessary to mitigate laser-related complications when using MLT tubes.
