Consistent Technique Limits Suspension Laryngoscopy Complications

Sean P Larner, Rick A Fornelli, Shane D Griffith, Sean P Larner, Rick A Fornelli, Shane D Griffith

Abstract

Introduction Suspension laryngoscopy (SL) is a commonly performed procedure among otolaryngologists. Several studies have shown that adverse effects occur regularly with SL. Objective To evaluate the postoperative complications of SL, and to determine if protecting the dentition and the oral mucosa and limiting suspension times decrease the overall incidence of oral cavity and pharyngeal complications of SL. Methods All of the cases of SL performed by 1 surgeon from November 2008 through September 2014 were retrospectively reviewed. A consistent technique for dental and mucosal protection was utilized, and suspension times were strictly limited to 30 consecutive minutes. The incidence of postoperative complications was calculated and analyzed with respect to gender, smoking status, dentition, laryngoscope type, and suspension system. Results A total of 213 consecutive SL cases were reviewed, including 174 patients (94 male, 80 female). The overall postoperative complication rate was of 3.8%. Four patients experienced tongue-related complications, two experienced oral mucosal alterations, one had a dental injury, and one experienced a minor facial burn. The complication incidence was greater with the Zeitels system (12.5%) compared with the Lewy suspension system (3.3%), although it was not significant ( p = 0.4). Likewise, the association of complications with other patient factors was not statistically significant. Conclusion Only 8 out of 213 cases in the present series experienced complications, which is significantly less than the complication rates observed in other reports. Consistent and conscientious protection of the dentition and of the oral mucosa and limiting suspension times to 30 minutes are factors unique to our series that appear to reduce complications in endolaryngeal surgery.

Keywords: endolaryngeal surgery; laryngoscopy complications; suspension laryngoscopy; suspension microlaryngoscopy.

Conflict of interest statement

Conflicts of Interest The authors have no conflicts of interest to declare.

References

    1. Hendrix R A, Ferouz A, Bacon C K. Admission planning and complications of direct laryngoscopy. Otolaryngol Head Neck Surg. 1994;110(06):510–516.
    1. Hill R S, Koltai P J, Parnes S M. Airway complications from laryngoscopy and panendoscopy. Ann Otol Rhinol Laryngol. 1987;96(06):691–694.
    1. Hochman I I, Zeitels S M, Heaton J T. Analysis of the forces and position required for direct laryngoscopic exposure of the anterior vocal folds. Ann Otol Rhinol Laryngol. 1999;108(08):715–724.
    1. Wenig B L, Raphael N, Stern J R, Shikowitz M J, Abramson A L. Cardiac complications of suspension laryngoscopy. Fact or fiction? Arch Otolaryngol Head Neck Surg. 1986;112(08):860–862.
    1. Gugatschka M, Gerstenberger C, Friedrich G. Analysis of forces applied during microlaryngoscopy: a descriptive study. Eur Arch Otorhinolaryngol. 2008;265(09):1083–1087.
    1. Jung H, Kim H J. Dexamethasone contributes to the patient management after ambulatory laryngeal microsurgery by reducing sore throat. Eur Arch Otorhinolaryngol. 2013;270(12):3115–3119.
    1. Rosen C A, Andrade Filho P A, Scheffel L, Buckmire R. Oropharyngeal complications of suspension laryngoscopy: a prospective study. Laryngoscope. 2005;115(09):1681–1684.
    1. Tessema B, Sulica L, Yu G P, Sessions R B. Tongue paresthesia and dysgeusia following operative microlaryngoscopy. Ann Otol Rhinol Laryngol. 2006;115(01):18–22.
    1. Landis B N, Giger R, Dulguerov P, Hugentobler M, Hummel T, Lacroix J S. Gustatory function after microlaryngoscopy. Acta Otolaryngol. 2007;127(10):1086–1090.
    1. Mohamad H, Mohamad I. Tongue paraesthesia and dysgeusia post suspension laryngoscopy. Kobe J Med Sci. 2012;58(02):E60–E62.
    1. Cinar U, Akgul G, Seven H, Celik M, Cinar S, Dadas B. Determination of the changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue. J Laryngol Otol. 2004;118(04):289–293.
    1. Gaut A, Williams M. Lingual nerve injury during suspension microlaryngoscopy. Arch Otolaryngol Head Neck Surg. 2000;126(05):669–671.
    1. Dos Anjos Corvo M A, Inacio A, de Campos Mello M B, Alessandra Eckley C, Campos Duprat A. Extra-laryngeal complications of suspension laryngoscopy. Rev Bras Otorrinolaringol (Engl Ed) 2007;73(06):727–732.
    1. Klussmann J P, Knoedgen R, Wittekindt C, Damm M, Eckel H E. Complications of suspension laryngoscopy. Ann Otol Rhinol Laryngol. 2002;111(11):972–976.
    1. Friedrich G, Gugatschka M. Influence of head positioning on the forces occurring during microlaryngoscopy. Eur Arch Otorhinolaryngol. 2009;266(07):999–1003.
    1. Fang R, Chen H, Sun J. Analysis of pressure applied during microlaryngoscopy. Eur Arch Otorhinolaryngol. 2012;269(05):1471–1476.
    1. Crossland G J, Pfleiderer A G. ‘Boil and Bite’ mouth guards for direct laryngoscopy. Clin Otolaryngol. 2007;32(02):121–122.

Source: PubMed

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