Preoperative Clinical Predictors of Difficult Laryngeal Exposure for Microlaryngoscopy: The Laryngoscore
Preoperative Clinical Predictors of Difficult Laryngeal Exposure for Microlaryngoscopy: The Laryngoscore
复制标题
DOI：
10.1002/lary.24803
复制
发表时间：
2014-11-01
期刊：
影响因子：
2.6
通讯作者：
Peretti, Giorgio
中科院分区：
文献类型：
--
作者：
Piazza, Cesare;Mangili, Stefano;Peretti, Giorgio
目的/假设为了确定一个临床预测评分的困难喉暴露（DLE）在手术显微喉镜。研究设计前瞻性队列研究在两个学术机构。方法我们评估了319例患者前显微喉镜良性和恶性声门疾病的标准化术前评估协议（喉评分），包括11个参数：门齿间隙（IIG）、甲颏距离、上颌牙齿状态、牙关紧闭、下颌缺颌、巨舌症、小颌症、颈部屈伸程度，既往开颈和/或放疗史、Mallampati改良评分和体重指数（BMI）。对每个参数进行评估以获得总分。根据前连合（AC）可视化将患者分为5类：0级，在Boyce-Jackson位置使用大口径喉镜完全AC可视化; I级，外部喉反压为0级; II级，在屈曲-屈曲位置为I级; III级，使用小口径喉镜为II级;结果0-I-II级（良好/可接受的喉暴露）的中位评分为
Objectives/HypothesisTo identify a clinical predictor score for difficult laryngeal exposure (DLE) during operative microlaryngoscopy.Study DesignProspective cohort study in two academic institutions.MethodsWe evaluated 319 patients before microlaryngoscopy for benign and malignant glottic diseases by a standardized preoperative assessment protocol (Laryngoscore) that included 11 parameters: interincisors gap (IIG), thyro-mental distance, upper jaw dental status, trismus, mandibular prognathism, macroglossia, micrognathia, degree of neck flexion-extension, history of previous open-neck and/or radiotherapy, Mallampati's modified score, and body mass index (BMI). Each parameter was assessed to obtain a total score. Patients were divided into five classes according to the anterior commissure (AC) visualization: class 0, complete AC visualization with large-bore laryngoscopes in the Boyce-Jackson position; class I, as class 0 with external laryngeal counterpressure; class II, as class I in the flexion-flexion position; class III, as class II using small-bore laryngoscopes; and class IV, impossible AC visualization.ResultsClass 0-I-II (good/acceptable laryngeal exposure) presented a median score