Do Intubation Devices Affect Middle Ear Pressure Dynamics?

J Craniofac Surg. 2019 Jun;30(4):1187-1190. doi: 10.1097/SCS.0000000000005258.

Abstract

Our study aimed to investigate the effects of different intubation devices on middle ear pressure (MEP) dynamics by evaluating MEP during stages of anesthesia.Sixty-one consecutive patients were randomly assigned to 2 groups: the classical endotracheal intubation group and the Baska Mask (a new laryngeal mask [LMA]) group. All patients received the same anesthesia protocol. The right and left MEP values of the patients were measured and recorded preoperatively, during the induction of anesthesia, at the time of intubation and at 5th minute of anesthesia.In group 1, the pressure values measured in the right ear during anesthesia induction, at the time of intubation and at 5th minute of anesthesia were 10.97 ± 27.06, 16.77 ± 29.40, and 21.64 ± 90.31, respectively, compared to left ear values of 8.61 ± 26.39, 18.77 ± 37.84, and 38.61 ± 56.96 daPa, respectively. In group 2, MEP values measured in the right ear during anesthesia induction, at the time of intubation, and at 5th minute of anesthesia were 9.53 ± 20.43, 22.30 ± 41.50, and 20.60 ± 46.85 daPa, respectively, compared to left ear values of -4.26 ± 25.17, 6.20 ± 26.56, and 30.30 ± 65.17 daPa, respectively. MEP was statistically significantly increased in the classical endotracheal intubation group compared to the LMA group.We found that the increase in pressure is lower in patients receiving LMA compared to classical endotracheal intubation. The Baska Mask LMA is recommended in selected patients to prevent complications of MEP elevation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acoustic Impedance Tests / methods*
  • Adult
  • Anesthesia, General / adverse effects*
  • Anesthesia, General / methods
  • Ear, Middle / physiopathology*
  • Female
  • Humans
  • Intubation, Intratracheal* / adverse effects
  • Intubation, Intratracheal* / instrumentation
  • Intubation, Intratracheal* / methods
  • Laryngeal Masks*
  • Male
  • Middle Aged
  • Nasal Surgical Procedures / adverse effects*
  • Nasal Surgical Procedures / methods
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control*
  • Pressure
  • Treatment Outcome