The effect of the laryngeal mask airway on the outcomesof the endoscopic tympanoplasty

The effect of the laryngeal mask airway on the outcomesof the endoscopic tympanoplasty

Aim: Chronic otitis media is a common disease characterized by a tympanic membrane perforation and conductive hearingloss. Tympanoplasty is performed to provide a healthy middle ear and to create an intact eardrum. In recent years, endoscopic tympanoplasty has become more popular for the repair of the tympanic membrane. This method saves time for the surgeon and provides a comfortable opportunity for the patient.Endotracheal intubation (ET) and laryngeal mask airway (LMA) are two different airway systems used in general anesthesia. It is known that LMA provides shorter operating times for surgeries requiring general anesthesia.The aim of this study was to evaluate the outcomes of endoscopic tympanoplasty in patients who underwent endoscopic tympanoplasty with LMA or ET anesthesia, and to compare this method that regards to graft success rates. We also investigated the duration of surgery and operation time, and pain scores in both groups.Materials and Methods: In this retrospective study, we included the patients who were performed endoscopic type 1 tympanoplastywith tragal cartilage graft. Visual evaluation of eardrums and audiologic datas of the patients were performed. The cases with cholesteatoma and/or ossicular chain problem were not included to study. Patients were evaluated in two different groups as LMA and endotracheal tube (ET) group. Preoperatively perforation types and audiological data; intraoperatively operation and surgical times; postoperatively 3th month surgical success, pain scores and audiological results were recorded in each group. And these results were evaluated statistically to compare the differences between LMA and ET group.Results: Ninety-three patients were included in the study and 36 of them underwent endoscopic tympanoplasty with LMA and 57patients with ET. The surgery time was similar in both groups (p> 0.05), but the operation time was statistically significantly shorter in the LMA group (p

___

  • 1. Indorewala S, Adedeji TO, Indorewala A, et al. Tympanoplasty outcomes: a review of 789 cases. Iran
  • J Otorhinolaryngol 2015;27:101-8.
  • 2. Ayala MA, Sanderson A, Marks R, et al. Laryngeal
  • mask airway use in otologic surgery. Otol Neurotol
  • 2009;30:599-601.
  • 3. McCrirrick A, Ramage DT, Pracilio JA, et al. Experience
  • with the laryngeal mask airway in two hundred
  • patients. Anaesth Intensive Care 1991;19:256-60.
  • 4. Braude N, Clements EA, Hodges UM, et al. The pressor
  • response and laryngeal mask insertion. A comparison
  • with tracheal intubation. Anaesthesia 1989;44:551-4.
  • 5. Furukawa T, Watanabe T, Ito T, et al. Feasibility and
  • advantages of transcanal endoscopic myringoplasty.
  • Otol Neurotol 2014;35:140-5.
  • 6. Liang S, Irwin MG. Review of anesthesia for middle ear
  • surgery. Anesthesiol Clin 2010;28:519-28.
  • 7. Kahl M, Eberhart LH, Behnke H, et al. Stress response
  • to tracheal intubation in patients undergoing
  • coronary artery surgery: direct laryngoscopy versus
  • an intubating laryngeal mask airway. J Cardiothorac
  • Vasc Anesth 2004;18:275-80.
  • 8. Torun MT, Kusderci HS, Oterkus M. Do Intubation
  • Devices Affect Middle Ear Pressure Dynamics? J
  • Craniofac Surg 2019;30:1187-90.
  • 9. Nader ND, Simpson G, Reedy RL. Middle ear pressure
  • changes after nitrous oxide anesthesia and its effect
  • on postoperative nausea and vomiting. Laryngoscope
  • 2004;114:883-6.
  • 10. Jefferson N, Riffat F, McGuinness J, et al. The laryngeal
  • mask airway and otorhinolaryngology head and neck
  • surgery. Laryngoscope 2011;121:1620-6.
  • 11. Gong Y, Xu X, Wang J, et al. Laryngeal mask airway
  • reduces incidence of post-operative sore throat after
  • thyroid surgery compared with endotracheal tube:
  • a single-blinded randomized controlled trial. BMC
  • Anesthesiol 2020;20:16.
  • 12. Reber A, Hauenstein L, Echternach M.
  • Laryngopharyngeal morbidity following general
  • anaesthesia. Anaesthesiological and laryngological
  • aspects. Anaesthesist 2007;56:177-89; quiz 90-1.
  • 13. van der Woerd B, Robichaud J, Gupta M. Parapharyngeal
  • abscess following use of a laryngeal mask airway
  • during open revision septorhinoplasty. Int J Surg Case
  • Rep 2015;16:198-201.
  • 14. Beswick DM, Collins J, Nekhendzy V, et al.
  • Chondronecrosis of the larynx following use of the
  • laryngeal mask airway. Laryngoscope 2015;125:946-
  • 9.
  • 15. Chan TV, Grillone G. Vocal cord paralysis after
  • laryngeal mask airway ventilation. Laryngoscope
  • 2005;115:1436-9.