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Atraumatic Intubation: Experience Using a 5.0 Endotracheal Tube Without a Stylet for Laryngeal Surgery
Journal article   Peer reviewed

Atraumatic Intubation: Experience Using a 5.0 Endotracheal Tube Without a Stylet for Laryngeal Surgery

Jaime E. Moore, Amanda Hu, Amy Rutt, Parmis Green, Mary Hawkshaw and Robert T. Sataloff
The Laryngoscope, v 125(2), pp 396-399
01 Feb 2015
DOI: https://doi.org/10.1002/lary.24891
PMID: 25123374

Abstract

Life Sciences & Biomedicine Medicine, Research & Experimental Otorhinolaryngology Research & Experimental Medicine Science & Technology
Objectives/Hypothesis: Vocal fold injury is a well-know complication of intubation, with rates reported as high as 69%. Laryngology textbooks recommend the use of a small endotracheal tube (ETT) to help avoid these complications and optimize visualization. Case reports have suggested that the rigid stylet can lead to laryngeal injury. Given the additional risks, intubation without the stylet is our preferred practice. There is limited documentation in the literature regarding this viewpoint. Our study investigated the feasibility of and potential barriers to intubation using 5.0 ETT without a stylet. Study Design: Prospective study. Methods: Consecutive adult patients undergoing laryngeal surgery were recruited for intubation with a 5.0 ETT without a stylet. Demographic data, specialty and training level of the intubator, and factors that would predict a difficult intubation were recorded. Descriptive statistical analysis was performed. Results: Findings of the participants (n=67) included average American Society of Anesthesiologists (ASA) physical status classification (2.2), average Mallampati score (1.7), average Cormack-Lehane grade (1.5), and average body mass index (28.0). Five patients (7.4%) required intubation using a stylet, and one of these five participants was intubated initially with a stylet. Of these five participants, 80% required use of a GlideScope (P<.001), and they had significantly higher ASA classification (P=.047) and number of intubation attempts (P=.042). One patient sustained an oropharyngeal injury during intubation with a stylet. No participants had laryngeal injury. Conclusions: Most patients can be intubated successfully using a 5.0 ETT without a stylet. There were no cases of laryngeal trauma with this technique.

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Collaboration types
Domestic collaboration
Web of Science research areas
Medicine, Research & Experimental
Otorhinolaryngology
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