Is it possible that direct rigid laryngoscope-related ischemia–reperfusion injury occurs in the tongue during suspension laryngoscopy as detected by ultrasonography: a prospective controlled study

Abstract

Background: Tongue-related complications can be seen in suspension laryngoscopy (SL) procedures.

Aims/objectives: This study aimed to detect tongue edema associated with the pressure exerted by a rigid direct laryngoscope by measuring the tongue area using ultrasonography (USG) in patients undergoing SL procedures.

Material and methods: The study group included 31 patients and the control group consisted of 33 patients. Submental USG examinations of the tongue in the coronal plane were performed. In the study and control groups, the first examination (TA¹) was done immediately after intubation and the second examination (TA²) was done after the surgery procedure but before extubation. The USG results regarding tongue area for both the groups were compared.

Results: The study and control groups significantly differed in terms of the postoperative tongue area measurements (TA²), as well as tongue edema (based on the TA² − TA¹) values.

Conclusions and significance: Direct rigid laryngoscopes may cause tongue edema in SL procedures which was demonstrated by the USG. This tongue edema can be a result of ischemia–reperfusion injury in the tongue due to the pressure exerted by a direct rigid laryngoscope. This study is the first to demonstrate the possible role of USG examination in determining the side effects of SL procedures on the tongue.

Trial Registration ClinicalTrials.gov Identifier: NCT04205253

Chinese abstract

背景：在悬浮喉镜检查（SL）过程中可见与舌相关的并发症。

目的：本研究旨在通过使用超声仪对接受SL手术的患者测量舌面积来检测硬直视喉镜导致的舌水肿。

材料与方法：研究组31例, 对照组33例患者。在冠状面上进行舌的颏下超声检查。在插管后对研究组和对照组立即进行第一次检查, 术后拔管前进行第二次检查。对两组的舌面积USG结果进行比较。

结果：研究组和对照组的术后舌面积测量值（TA2）及和舌水肿值（基于TA2_TA1）有显著差异。

结论与意义：直硬喉镜在SL手术中可引起舌水肿, USG已经证明了这一点。舌水肿可能是由于直接硬喉镜的压迫而造成的舌头损伤, 从而引起缺血再灌注的结果。该项研究第一次证明USG检查在确定SL手术对舌的副作用方面的可能意义。

Keywords:

• Diagnosis
• ultrasonic
• laryngoscopic surgical
• complications
• tongue disease

Disclosure statement

No potential conflict of interest was reported by the author(s).