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.