[Difficult intubation in otorhinolaryngologic laser surgery. Is there a predictive parameter?]

Abstract

In the planning of laser surgery for ENT operations, the specialist is often consulted by the anesthesiologist to predict possible intubation problems. Intubation problems in such operations can occur frequently due to the pathological findings present in the upper aerodigestive tract and the different constructions of laser-resistant endotracheal tubes. The aim of this study was to determine if a known predictive parameter could have a sufficient sensitivity and specificity to reliably predict possible intubation problems for ENT-related laser surgery. In a prospective study, 91 patients were included and the Mallampati-score modified by Samsoon and Young was analyzed and compared to a score describing the actual conditions of intubation. The results showed a significant correlation (p < 0.05, Chi-Square test). However, the specificity was only 72% and the sensitivity of 60% was too low to be of practical use. The results were independent of the endotracheal tube used. Although use of the laser for ENT operations provides a special situation for the anesthesiologist, there is still no system that is sensitive and specific enough to be of practical use. This problem is demonstrated in a literature review.