张口仰头含牙颈部侧位片在预测困难支撑喉镜中的应用

Objective To evaluate the effectiveness of a special head and neck lateral X-ray on preoperative prediction for the difficulty of laryngeal exposure suspension larygoscopy.Methods From Oct. 2010 to Feb. 2012, 77 patients who underwent microlaryngosurgery were enrolled in this study. Preoperative lateral X-ray films of the head and neck were taken with the patient standing with head extended and mouth fully opened, 8 measurements including thyromental distance (mm), thyrolingual distance (mm), hyomental distance (mm), vertical distance of hyoid bone to thyromental distance (mm), thyrolingualmandible angle (°), upper incisor length (mm), interincisor gap (mm) and thickness of tongue (mm) were made on each film, and compared with visual analogue scale,(VAS) score for difficulty of laryngeal exposure during the operation by the surgeon. A prediction scale was created based on the statistical results. Results Vertical distance from hyoid bone to thyromental distance (B=0.109,P=0.014) and upper incisor length (B=0.179,P=0.023) were positively correlated with the VAS score for the difficulty of laryngeal expasure in suspension laryngoscopy. Hgomental distance (B=0.090,P=0.011) and interincisor gap (B=-0.098,P=0.000) were proved to be negatively correlated with the VAS score for the difficulty of laryngeal exposure in suspension laryngoscopy.Conclusions Preoperative measurement of special parameters on lateral X-ray films of head and neck may be useful for prediction of difficult laryngeal exposure in suspension laryngoscopy.