دورية أكاديمية
Laryngoscopies in the obese: predicting problems and optimizing visualization.
| العنوان: | Laryngoscopies in the obese: predicting problems and optimizing visualization. |
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| المؤلفون: | Hekiert AM; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia 19104, USA., Mandel J, Mirza N |
| المصدر: | The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2007 Apr; Vol. 116 (4), pp. 312-6. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Country of Publication: United States NLM ID: 0407300 Publication Model: Print Cited Medium: Print ISSN: 0003-4894 (Print) Linking ISSN: 00034894 NLM ISO Abbreviation: Ann Otol Rhinol Laryngol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Los Angeles : Sage Original Publication: St. Louis : Annals Publishing Co |
| مواضيع طبية MeSH: | Glottis/*pathology , Hypopharynx/*physiology , Laryngoscopy/*methods , Obesity/*pathology , Oropharynx/*pathology, Adult ; Aged ; Body Mass Index ; Female ; Humans ; Intubation, Intratracheal/methods ; Male ; Middle Aged ; Pilot Projects ; Prognosis ; Retrospective Studies ; Sex Factors |
| مستخلص: | Objectives: This pilot study was designed to 1) identify predictors of difficult laryngeal exposure in obese patients, 2) develop strategies for efficient intubation and intraoperative visualization of the glottis, and 3) devise perioperative protocols for difficult laryngoscopies. Methods: We undertook a retrospective study over a 1-year period of 14 consecutive patients with a body mass index of more than 30 kg/M2 who underwent elective direct laryngoscopy under general anesthesia. Measurements of height, weight, neck circumference, Mallampati score, and Cormack-Lehane classification of the airway were recorded. Problems encountered during anesthesia induction and emergence were also noted. The laryngologist recorded on a visual analog scale the degree of difficulty encountered in obtaining a binocular stereoscopic view and magnification, illumination, and suspension. Results: Anatomic challenges during difficult laryngoscopy included decreased neck extension, redundant folds of tissue in the oropharynx and hypopharynx, and upper airway collapsibility. Overall, there was an association between the incidence of difficult laryngeal exposure and the Cormack-Lehane score (r = .57; p = .03), but the Mallampati score was of limited utility to the laryngologist. Neck size in female patients correlated with the Cormack-Lehane score (p = .02). Neither weight nor body mass index were predictive of a difficult laryngeal exposure. Straight blade laryngoscopes with a distal flange allowed greater depth of insertion and provided the best visualization of the glottis. Conclusions: An appropriate clinical examination may help predict a difficult airway. However, further studies are warranted to fully characterize the anatomic predictors of a difficult laryngeal exposure. |
| تواريخ الأحداث: | Date Created: 20070512 Date Completed: 20070524 Latest Revision: 20170214 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1177/000348940711600416 |
| PMID: | 17491533 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 0003-4894 |
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| DOI: | 10.1177/000348940711600416 |