Abstract
Objectives: In most cases, suspension laryngoscopy (SL) is efficient,
bloodless and with minimal post-procedure discomfort. We aimed to
identify predictive patient factors for acceptable surgical views at SL
as well as quantify our tertiary airway unit’s complication rates.
Design: Prospective cohort study of 150 consecutive microlaryngoscopy
procedures involving SL over an 8-month period between November 2019 and
July 2020. Patients were assessed pre-operatively for pre-existing oral,
temporomandibular, dental, pharyngeal or laryngeal pathology,
interincisor distance and qualitative gross limitations to neck
extension and forward head posture. Intraoperatively, the laryngoscopic
view was graded by anesthetic and surgical teams, and complications were
recorded on patient interview in recovery.
Setting: Tertiary adult airway service for predominantly benign
pathology.
Results: Adequate surgical views were obtained in 149/150 procedures.
BMI and limitations to chin and neck movement had mild positive
correlations with more difficult views in their own rights, but did not
correlate with a statistically significant increase in complications.
There was a negative correlation between age and interincisor gap
(p=0.014), and wider mouth opening correlated with a lower incidence of
sore throat (p=0.023). Macroglossia showed a statistically significant
positive correlation with tongue symptoms
(p=1.611x10-8).
Conclusion: In the context of an experienced airway unit with a high
caseload of predominantly benign pathology, SL is very effective and
safe with low associated morbidity and no mortality. Patient-reported
neck and chin movement were found to correlate well with the surgical
view obtained. The most common complication of SL is temporary sore
throat and there remain recognized risks of temporary tongue and dental
symptoms.
Keywords : Suspension laryngoscopy; direct laryngoscopy;
surgical complications; laryngeal exposure