Difficult intubation in ENT patient: Simultaneous videolaryngoscopy with flexible bronchoscopy. A combined approach. Case report

Ottoveggio, Gaetano; Verro, Barbara; Lapi, Maria; Tarantino, Francesco; Beccia, Giovanna; Saraniti, Carmelo

doi:10.1016/j.ijscr.2024.109345

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…As previously mentioned, there is a growing tendency to use modern diagnostic and visual technologies in patients when there is a predicted high risk for difficult intubation. There is a special need for their use in laryngology since airway pathology can severely compromise endotracheal intubation [11,29,30]. The AUC of flexible laryngoscopy in our study was 0.766, which correlated with the results of Gemma et al who tested the accuracy of flexible laryngoscopy in ENT patients [13].…”

Section: Discussionsupporting

confidence: 87%

Prediction of a Difficult Airway Using the ARNE Score and Flexible Laryngoscopy in Patients with Laryngeal Pathology

Marković,

Šurbatović,

Milisavljević

et al. 2024

Medicina

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Background and Objectives: The ARNE score was developed for the prediction of a difficult airway for both general and ear, nose and throat (ENT) surgery with a universal cut-off value. We tested the accuracy of this score in the case of laryngeal surgery and provided an insight into its effects in combination with flexible laryngoscopy. Materials and Methods: This prospective pilot clinical study included 100 patients who were being scheduled for microscopic laryngeal surgery. We calculated the ARNE score for every patient, and flexible laryngoscopy was provided preoperative. Difficult intubation was assessed according to the intubation difficulty score (IDS). Results: A total of 33% patients had difficult intubation according to the IDS. The ARNE score showed limited accuracy for the prediction of difficult intubation in laryngology with p < 0.0001 and an AUC of 0.784. Flexible laryngoscopy also showed limitations when used as an independent parameter with p < 0.0001 and an AUC of 0.766. We defined a new cut-off value of 15.50 for laryngology, according to the AUC. After the patients were divided into two groups, according to the new cut-off value and provided cut-off value, the AUC improved to 0.707 from 0.619, respectively. Flexible laryngoscopy improved the prediction model of the ARNE score to an AUC of 0.882 and of the new cut-off value to an AUC of 0.833. Conclusions: It is recommended to use flexible laryngoscopy together with the ARNE score in difficult airway prediction in patients with laryngeal pathology. Also, the universally recommended cut-off value of 11 cannot be effectively used in laryngology, and a new cut-off value of 15.50 is recommended.

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Section: Discussionsupporting

confidence: 87%

Prediction of a Difficult Airway Using the ARNE Score and Flexible Laryngoscopy in Patients with Laryngeal Pathology

Marković,

Šurbatović,

Milisavljević

et al. 2024

Medicina

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Prediction of Difficult Airway Using Arne Score and Flexible Laryngoscopy in Patients with Laryngeal Pathology

Markovic,

Šurbatović,

Milisavljević

et al. 2024

Preprint

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Background and Objectives: ARNE score was developed for the prediction of difficult airway for both general and ENT surgery with a universal cut-off value. We tested the accuracy of this score in the case of laryngeal surgery and provided an insight of its combination with flexible laryngoscopy. Materials and Methods: This prospective pilot clinical study included 100 patients who were being scheduled for microscopic laryngeal surgery. We have calculated ARNE score for every patient and flexible laryngoscopy was provided preoperative. Difficult intubation was assessed according to intubation difficulty score (IDS). Results: A total of 33% patients had difficult intubation according to IDS. ARNE score showed to be accurate for prediction of difficult intubation in laryngology with P&lt;0.0001 and AUC 0.784. Flexible laryngoscopy showed to be an independent parameter with P&lt;0.0001 and AUC 0.766. We have defined a new cut-off value of 15.50 for laryngology, according to AUC curve. After the patients were divided in two groups, according to the new cut-off value and provided cut-off value, AUC improved to 0.707 from 0.619 respectively. Flexible laryngoscopy improved the prediction model of ARNE score to AUC 0.882 and of new cut-off value to AUC 0.833. Conclusions: It is recommended to use flexible laryngoscopy together with ARNE score in difficult airway prediction in patients with laryngeal pathology. Also, universally recommended cut-off value of 11 can not be effectively used in laryngology and a new cut-off value of 15.50 is recommended.

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Difficult intubation in ENT patient: Simultaneous videolaryngoscopy with flexible bronchoscopy. A combined approach. Case report

Cited by 2 publications

References 17 publications

Prediction of a Difficult Airway Using the ARNE Score and Flexible Laryngoscopy in Patients with Laryngeal Pathology

Prediction of a Difficult Airway Using the ARNE Score and Flexible Laryngoscopy in Patients with Laryngeal Pathology

Prediction of Difficult Airway Using Arne Score and Flexible Laryngoscopy in Patients with Laryngeal Pathology

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