HNO · 2002
[Prognostic value of a screening test for difficult microlaryngoscopy].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Müller A, Verges L, Gottschall R
Аннотация
BACKGROUND: Several screening methods for the prediction of a difficult endotracheal intubation such as the test by Patil or the Mallampati-Score have been described. The incidence of difficult microlaryngoscopic procedures and the prognostic value of those screening tests for their prediction has not been investigated.
PATIENTS AND METHODS: We examined 81 patients with mainly benign conditions of the larynx in a prospective study to evaluate the maximal overview of the glottis gained during microlaryngoscopy under supraglottic jetventilation. We used a specially designed ruler to measure the length of the invisible portion of the glottis.
RESULTS: The incidence of a difficult microlaryngoscopy was 4.9%. All employed screening scores did not reach a satisfactory positive predictive value (PPV). The routine indirect laryngoscopy with phonation had the highest PPV (50%) of all tests.
CONCLUSION: Therefore an impossible indirect laryngoscopy can be regarded as a warning sign for a difficult microlaryngoscopic procedure. Summation-scores like the Arné Multivariate Risk Index or the use of check lists (Benumof) may improve the predictive value of preoperative screening.
PATIENTS AND METHODS: We examined 81 patients with mainly benign conditions of the larynx in a prospective study to evaluate the maximal overview of the glottis gained during microlaryngoscopy under supraglottic jetventilation. We used a specially designed ruler to measure the length of the invisible portion of the glottis.
RESULTS: The incidence of a difficult microlaryngoscopy was 4.9%. All employed screening scores did not reach a satisfactory positive predictive value (PPV). The routine indirect laryngoscopy with phonation had the highest PPV (50%) of all tests.
CONCLUSION: Therefore an impossible indirect laryngoscopy can be regarded as a warning sign for a difficult microlaryngoscopic procedure. Summation-scores like the Arné Multivariate Risk Index or the use of check lists (Benumof) may improve the predictive value of preoperative screening.