Determination of the Difficult Intubation Incidence and its Affecting Factors in Patients Undergoing Septal Deviation Surgery – Prospective Controlled Trial

Objective: The aim of this prospective clinical study was to compare the incidence of difficult airway in patients undergoing septal deviation with the incidence of difficult airway in patients undergoing tympanoplasty and to determine the factors associated with the incidence of the difficult airway. Investigation of predisposing factors for difficult airway in patients undergoing septal deviation surgery was evaluated as a secondary outcome. Methods: A total of 255 participants, 130 patients undergoing septoplasty (study group- Group S) and 125 patients undergoing tympanoplasty (control group-Group T) were included in this study. Preoperative airway evaluation was performed using the LEMON protocol. For all patients, the STOP-BANG questionnaire was performed to identify the risk of Obstructive Sleep Apnea Syndrome (OSAS). Cormack-Lehane laryngeal view grades were noted during laryngoscopy. The definition of difficult intubation was identified according to the Cormack-Lehane scale (I–II=easy, III–IV=difficult). Additionally, the intubation method used, number of intubation attempts, use of stylet, cricoid pressure, and usage of airway were recorded. Results: There were no unintubated patients in this study population. Cormack-Lehane score and incidence of difficult airway were significantly higher in the Group S than the Group T (p

Septal Deviasyon Ameliyatı Geçirecek Hastalarda Zor Entübasyon İnsidansının ve Etki Eden Faktörlerin Belirlenmesi: Prospektif Kontrollü Çalışma

Amaç: Bu prospektif klinik çalışmanın amacı septal deviasyon ameliyatı geçirecek hastalardaki zor havayolu insidansını timpanoplasti operasyonu geçirecek hastalardaki zor havayolu insidansı ile karşılaştırmak ve zor havayolu insidansına etki eden faktörlerin belirlenmesidir. Septal deviasyon ameliyatı geçirecek hastalardaki zor havayolu için predispozisyon yaratan faktörlerin araştırılması ikincil çıktı olarak değerlendirilmiştir. Gereç ve Yöntem: Çalışmaya septoplasti (çalışma grubu-Grup S) uygulanan 130 hasta ve timpanoplasti (kontrol grubu-Grup T) uygulanan 125 hasta olmak üzere toplam 255 katılımcı dahil edildi. Operasyon öncesi havayolu değerlendirilmesi LEMON protokolü kullanılarak yapıldı. Bütün hastalara uyku apne sendromu (UAS) risk tanısı için STOP-BANG soru testi uygulandı. Laringoskopi sırasında Cormack-Lehane laringeal görüntü dereceleri not edildi. Cormack-Lehane skalasına göre zor havayolu tanımlaması yapıldı (I–II=kolay, III–IV=zor). Ek olarak kullanılan entübasyon yöntemi, entübasyon deneme sayısı, stile kullanımı, krikoid bası ve airway kullanımı kaydedildi. Bulgular: Bu çalışma popülasyonunda entübe edilemeyen hasta olmadı. Cormack-Lehane skoru ve zor havayolu insidansı Grup S’de Grup T’ye göre anlamlı olarak daha yüksek bulundu (p

Kaynakça

1. Özkırış M, Mutlu C. The incidence of nasal septal deviation in patients admitted to our ENT clinic. J Kartal TR 2010;21:72–6.

2. Linder-Aronson S. Adenoids: their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the dentition: a biometric, rhino-manometric and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl 1970;265:1–132.

3. Principato JJ. Upper airway obstruction and craniofacial morphology. Otolaryngol Head Neck Surg 1991;104:881–90.

4. Liistro G, Rombaux P, Belge C, Dury M, Aubert G, Rodenstein DO. High Mallampati score and nasal obstruction are associated risks factors for obstructive sleep apnea. Eur Respir J 2003;21:248–52.

5. Lofaso F, Coste A, d’Ortho MP, Zerah-Lancner F, Delclaux C, Goldenberg F, et al. Nasal obstruction as a risk factor for obstructive sleep apneoa syndrome. Eur Respir J 2000;16:639–43.

6. Yang WH, Drouin MA, Herbert M, Mao Y, Karsh J. Nasal obstructions as a risk factor for sleep-disordered breathing. The University of Winsconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997;99:757–62.

7. Josell SD. Habits affecting dental and maxillofacial growth and development. Dent Clin North Am 1995;39:851–60.

8. Valera FC, Travitzki LV, Mattar SE, Matsumoto MA, Elias AM, Anselmo-Lima WT. Muscular, functional and orthodontic changes in preschool children with enlarged adenoids and tonsils. Int J Pediatr Otorhinolaryngol 2003;67:761–70.

9. Singh A, Patel N, Kenyon G, Donaldson G. Is there objective evidence that septal surgery improves nasal airflow? J Laryngol Otol 2006;120:916–20.

10. Virkkula P, Bachour A, Hytönen M, Salmi T, Malmberg H, Hurmerinta K, et al. Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance. Chest. 2006;129:81–7.

11. Pirsig W. Growth of the deviated septum and its influence on midfacial development. Facial Plast Surg 1992;8:224–32.

12. Hafezi F, Naghibzadeh B, Nouhi A, Yavari P. Asymmetric facial growth and deviated nose: a new concept. Ann Plast Surg 2010;64:47–51.

13. Kim YM, Rha KS, Weissman JD, Hwang PH, Most SP. Correlation of asymmetric facial growth with deviated nasal septum. Laryngoscope 2011;121:1144–8.

14. Reed MJ, Dunn MJ, McKeown DW. Can an airway assessment score predict difficulty at intubation in the emergency department? Emerg Med J 2005;22:99–102.

15. Sagarin MJ, Barton ED, Chng YM, Walls RM; National Emergency Airway Registry Investigators. Airway management by US and Canadian emergency medicine residents: a multicenter analysis of more than 6,000 endotracheal intubation attempts. Ann Emerg Med 2005;46:328–36.

16. Calder I. Identification of the Difficult Airway. Anaesthesia 2011;12:340–2.

17. Mallampati SR. Clinical assessment of airway. Anesthesiol Clin north Am 1995;13:301–7.

18. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 2008;108:812–21.

19. Cattano D, Panicucci E, Paolicchi A, Forfori F, Giunta F, Hagberg C. Risk Factors Assessment of the Difficult Airway: An Italian Survey of 1956 Patients. Anesth Analg 2004;99:1774–9.

20. Duchynski R, Brauer K, Hutton K, Jones S, Rosen P. The quick look airway classification. A useful tool in predicting the difficult out-ofhospital intubation: experience in an air medical transport program. Air Med J 1998;17:46–50.

21. Hasegawa K, Shigemitsu K, Hagiwara Y, Chiba T, Watase H, Brown CA 3rd, et al. Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study. Ann Emerg Med 2012;60:749–54.e2.

22. Hiremath AS, Hillman DR, James AL, Noffsinger WJ, Platt PR, Singer SL. Relationship between difficult tracheal intubation and obstructive sleep apnoea. Br J Anaesth 1998;80:606–11.

23. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2017;13:479–504.

24. Turhan M, Bostancı A, Akdag M, Dinc O. A comparison of the effects of packing or transseptal suture on polysomnographic parameters inseptoplasty. Eur Arch Otorhinolaryngol 2013;270:1339–44.

25. Shah PN, Sundaram V. Incidence and predictors of difficult mask ventilation and intubation. J Anaesthesiol Clin Pharmacol 2012;28:451–5.

Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

655117

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