Application of difficult endotracheal intubation under fluoroscopy in otorhinolaryngology head and neck surgery

Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5401-5405. doi: 10.1007/s00405-022-07456-x. Epub 2022 May 30.

Abstract

Purpose: Thyroid cancer, laryngeal cancer and retrosternal goiter are common diseases of head and neck, which often causes difficulty breathing and dyspnea. However, it is usually hard to use conventional methods to deal with this problem. The purpose of this study was to evaluate the safety and effectiveness of an interventional technique for difficult endotracheal intubation (DEI) caused by head and neck diseases.

Methods: We retrospectively analyzed the clinical data of 35 patients who underwent an interventional technique for difficult endotracheal intubation and evaluated the efficacy of this approach and observe postoperative pulse oxygen saturation (SpO2), Hugh-Jones grade, and complications.

Results: The procedures were successfully completed in all patients who underwent DEI. The technical and clinical success rate of the procedures was 100%. The average procedure duration was 3.2 ± 1.1 min (range 1-5 min). The patients' postoperative SpO2 and Hugh-Jones grade improved, and dyspnea symptoms resolved. There were no serious EI-related complications.

Conclusions: Interventional EI under fluoroscopy is a safe, simple, and fast method for accurate intubation and an effective method for DEI; furthermore, it allows for subsequent clinical treatment.

Keywords: Dyspnea; Endotracheal intubation; Head and neck diseases; Interventional radiology; Tracheal stenosis.

MeSH terms

  • Dyspnea / etiology
  • Fluoroscopy
  • Humans
  • Intubation, Intratracheal* / adverse effects
  • Otolaryngology*
  • Retrospective Studies