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Oropharyngeal injuries associated to video laryngoscopy intubation
Lesiones orofaríngeas asociadas a la intubación con videolaringoscopio
M. López-Baamonde
, M. Arias Salazar, M. Ubré, J. Martínez Ocón
Corresponding author
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain
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A) Visión desde el exterior de la cavidad oral. B) Imagen con detalle del videolaringoscopio utilizado (GlideScope®). C) Imagen del videolaringoscopio con visualización franca de la perforación del pilar amigdalino. D) Imagen del videolaringoscopio, avanzando desde la visión previa, que muestra la epiglotis y confirma la intubación traqueal. Flecha verde: porción lesionada de la mucosa del pilar amigdalino. Flecha amarilla: epiglotis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. López-Baamonde, M. Arias Salazar, M. Ubré, J. Martínez Ocón" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "López-Baamonde" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Arias Salazar" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Ubré" ] 3 => array:2 [ "nombre" => "J." 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López-Baamonde, M. Arias Salazar, M. Ubré, J. Martínez Ocón" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "López-Baamonde" "email" => array:1 [ 0 => "manuellopezbaamonde@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Arias Salazar" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Ubré" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Martínez Ocón" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones orofaríngeas asociadas a la intubación con videolaringoscopio" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2313 "Ancho" => 3083 "Tamanyo" => 628292 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The pharyngeal injury caused by videolaryngoscopy intubation (perforation of the tonsillar pillar) from different angles. A) View from outside the oral cavity. B) Detail of the video laryngoscope used (GlideScope®). C) Video laryngoscope image with visualization of tonsillar pillar perforation. D) Video laryngoscope image, advancing from the previous view, showing the epiglottis and confirming tracheal intubation. Green arrow: injured portion of the mucosa of the tonsillar pillar. Yellow arrow: epiglottis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Video laryngoscopy has reduced the incidence of intubation failure compared to conventional laryngoscopy, particularly in cases of difficult airway. However, many studies describe how intubation with a video laryngoscope can cause injury to the airway and pharynx, usually involving perforation of the soft palate and tonsillar pillars during insertion of the tracheal tube.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Video laryngoscopes with sharp angles, such as the GlideScope® (Verathon®) require the use of a curved stylet that significantly increases the risk of injury. During intubation, focusing attention on the video laryngoscope screen creates a blind spot in the oropharynx that prevents visualization of the endotracheal tube from the time it is inserted into the oral cavity until it reappears in view of the camera.</p><p id="par0015" class="elsevierStylePara elsevierViewall">As an example, we present the image (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showing perforation of the tonsillar pillar and dissection of the mucosa during intubation with GlideScope® in a morbidly obese patient. The perforation was identified by observing slight bleeding from the oral cavity after intubation. The otorhinolaryngologist repaired the injury with a simple dissection and suturing of the mucosa. The procedure was uneventful.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In general, lesions of the tonsillar pillars can be successfully managed with conservative treatment, dissection or surgical suture. While performing video laryngoscope intubation, it is important to visualize the endotracheal tube at all times.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have not received specific funding from agencies in the private public and nonprofit sectors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Baamonde M, Arias Salazar M, Ubré M, Martínez Ocón J. Lesiones orofaríngeas asociadas a la intubación con videolaringoscopio. Rev Esp Anestesiol Reanim. 2022;69:125–126.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2313 "Ancho" => 3083 "Tamanyo" => 628292 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The pharyngeal injury caused by videolaryngoscopy intubation (perforation of the tonsillar pillar) from different angles. A) View from outside the oral cavity. B) Detail of the video laryngoscope used (GlideScope®). C) Video laryngoscope image with visualization of tonsillar pillar perforation. D) Video laryngoscope image, advancing from the previous view, showing the epiglottis and confirming tracheal intubation. Green arrow: injured portion of the mucosa of the tonsillar pillar. Yellow arrow: epiglottis.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006900000002/v1_202203120614/S2341192922000233/v1_202203120614/en/main.assets" "Apartado" => array:4 [ "identificador" => "70433" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006900000002/v1_202203120614/S2341192922000233/v1_202203120614/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000233?idApp=UINPBA00004N" ]
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