Complication Rates
There were no episodes of major cardiorespiratory instability related to
SL itself, although one patient suffered a short but major drop in
oxygen saturations in response to the apneic period during subglottic
balloon dilatation. 4 further patients required temporary intraoperative
intubation to allow positive pressure ventilation and recruitment
maneuvers as SJV alone was insufficient to maintain oxygen saturations;
all patients were successfully extubated post-procedure. No other major
complications were encountered over this data collection period.
The rates of minor complications associated with SL are shown in Table
3. The most common complication was that of a temporary sore throat
without significant dysphagia (66%), which universally resolved by the
third postoperative day. On multivariate analysis, the incidence of sore
throat was negatively correlated with interincisor gap (r=-0.186,
p=0.023) – although interincisor gap was also negatively correlated
with age (r=-0.2, p=0.014), no significant direct correlation was found
between age and sore throat. Tongue symptoms occurred in 10 cases
(6.7%), all of which were mild and temporary sensory disturbances.
These positively correlated with macroglossia on multivariate analysis
(r=0.452, p=1.611x10-8). No incidences of tongue
weakness occurred in our cohort. Oropharyngeal trauma occurred in 4
patients (2.7%) – these were mild in all cases. Dental and
temporomandibular joint pain were reported in a further 2 cases, both of
which were exacerbations of pre-existing symptoms on further
questioning. There were no incidences of dental loosening or injury.
Despite correlations with poor grades of view, the chosen markers for
unfavorable patient body habitus did not significantly correlate with
increases in complications. No other statistically significant
correlations between patient or procedural factors and complications
were identified.