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Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures
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  • Elizabeth Maughan,
  • Anthony Rotman,
  • Maral Rouhani,
  • Gerard Thong,
  • James Poncia,
  • John Myatt,
  • Chadwan Al Yaghchi,
  • Gurpreet Sandhu
Elizabeth Maughan
Charing Cross Hospital
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Anthony Rotman
Charing Cross Hospital
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Maral Rouhani
Charing Cross Hospital
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Gerard Thong
Charing Cross Hospital
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James Poncia
Charing Cross Hospital
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John Myatt
Charing Cross Hospital
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Chadwan Al Yaghchi
Imperial College Healthcare NHS Trust
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Gurpreet Sandhu
Imperial College Healthcare NHS Trust
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Abstract

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.

Peer review status:UNDER REVIEW

07 Dec 2020Submitted to Clinical Otolaryngology
09 Dec 2020Submission Checks Completed
09 Dec 2020Assigned to Editor
27 Dec 2020Reviewer(s) Assigned
21 Jan 2021Review(s) Completed, Editorial Evaluation Pending
07 Feb 2021Editorial Decision: Revise Major
22 Feb 20211st Revision Received
27 Feb 2021Submission Checks Completed
27 Feb 2021Assigned to Editor
07 Mar 2021Reviewer(s) Assigned
11 Apr 2021Review(s) Completed, Editorial Evaluation Pending
02 May 2021Editorial Decision: Revise Minor
11 May 20212nd Revision Received
13 May 2021Submission Checks Completed
13 May 2021Assigned to Editor
14 Jun 2021Reviewer(s) Assigned