Data Collection
Age, gender at birth, height, weight, dentition, gross macroglossia and
Mallampati score were pre-operatively recorded. On the day of surgery,
patients were assessed by both surgical and anesthetic teams for the
presence of pre-existing oral, temporomandibular, dental, pharyngeal or
laryngeal pathology. The maximum inter-incisor gap achievable by the
conscious patient was also quantitively measured, as well as any gross
limitations to comfortable neck extension and forward head posture -
reasons for limitations included high muscle mass/body mass index (BMI)
or cervical spine immobilization (Figure 2).
Intraoperatively, laryngoscopic view was independently graded with
reference to the Modified Cormack-Lehane System (MCLS, Table 1) by both
anesthetist and surgeon using their usual laryngoscopes. The duration of
time spent in suspension and the occurrence of major adverse events were
also recorded (e.g. major cardiovascular instability, deep prolonged
desaturations or airway fires). As far as practicable, surgical
assessment of view was blinded with respect to preoperative measurements
and anesthetic view.
Post-operatively, patients were specifically asked about symptoms
relating to SL complications by a surgical team member. Any
patient-reported symptoms were monitored by telephone follow-up on the
first postoperative day and subsequently monthly until resolution.