Updated protocol proposed following an endoscopic study on intubation of the „pathological larynx“. Applications

Abstract

The anaesthesia and ICU doctor is confronted daily with the oro-tracheal intubation maneuver. We tried to identify by video-endoscopic means lesions or primary laryngeal dysfunctions on which the success and quality of general intubation / anesthesia as well as the prevention of secondary laryngeal and laryngotracheal lesions depend. We performed a prospective, observational, analytical and statistical study based on laryngeal and anatomical perimeter video-endoscopy, a study that included 1,031 orotracheal intubations (OTI) from which we selected 52 clinical cases relevant to the context of difficult intubation on pathological larynx. We used in a proportion of 64% fiber-optic as a technological means of exposing the larynx for oro-tracheal intubation (OTI) to prevent a difficult oro-tracheal intubation (IOT) or to complete it. An updated protocol was proposed in order to identify the pathological larynx, the lesions secondary to the intubation maneuver, the emergencies.

Keywords

• pathological larynx
• fiber-optic video-endoscopy
• endoscopic follow-up