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doi: 10.1016/j.otorri.2013.04.004

Evaluación de la vía aérea mediante laringoscopia indirecta en pacientes con hipertrofia de la amígdala lingual

Airway evaluation by indirect laryngoscopy in patients with lingual tonsillar hypertrophy

Jorge Sánchez-Morillo a, , Lorena Gómez-Diago a, Pablo Rodríguez-Gimillo a, Raúl Herrera-Collado a, Jorge Puchol-Castillo a, Luis Mompó-Romero b

a Servicio de Anestesiología y Reanimación, Hospital Universitario Dr. Peset, Valencia, España
b Servicio de Otorrinolaringología, Hospital Universitario Dr. Peset, Valencia, España

Palabras Clave

Laringoscopia indirecta. Laringoscopio rígido. Laringoscopia directa. Vía aérea difícil. Amígdala. Hipertrofia.

Keywords

Indirect laryngoscopy. Rigid laryngoscope. Direct laryngoscopy. Difficult airway. Tonsil. Hypertrophy.

Resumo

Introduction and objectives

Prevalence of the lingual tonsillar hypertrophy is unknown but it is believed that its presence is associated with the difficult airway. To investigate this, indirect laryngoscopy was performed on patients in the preoperative evaluation and this pathology was diagnosed. The relationship with difficulty of viewing the larynx, intubation and ventilation, under general anaesthesia and using direct laryngoscopy, was then studied.

Methods

We performed the demographic variable checks and tests for predicting difficult intubation (mouth opening, thyromental distance, cervical flexion-extension, neck thickness and Mallampati test), in the preoperative step on 300 patients who were going to be submitted to general anaesthesia. We then performed indirect laryngoscopy on them using a 70° rigid laryngoscope to ascertain the frequency of appearance of lingual tonsillar hypertrophy. Next, under general anaesthesia, we carried out direct laryngoscopy to verify whether there was difficulty in viewing the larynx and intubation and ventilation. We then investigated the association of demographic predictors of difficult intubation, including indirect laryngoscopy, with the presence of this condition.

Results

Prevalence of lingual tonsillar hypertrophy was 2%. No relationship between the appearance of this entity and the difficulty of viewing the larynx, intubation and ventilation was found. Only indirect laryngoscopy was linked to the appearance of this pathology.

Conclusions

Lingual tonsillar hypertrophy is a relatively frequent disorder, whose presence is not usually associated with difficult airway.

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