Difficult Intubation in Patients with Carcinoma of the Larynx and Hypopharynx

Abstract

Introduction: ASA defines difficult intubation as tracheal intubation which requires more than three attempts with direct laryngoscopy. In a major study including 3325 patients, three or more attempts for direct laryngoscopy were needed in 1,9%, and intubation failure was observed in 0,1%. The Aim of the study is to determine difficult intubation rates in patients with laryngeal and hypopharyngeal carcinoma. Materials and Methods: A prospective cohort study including 100 patients undergoing microlaryngeal surgery in the Department of Otorhinolaryngology at the University Hospital „Queen Giovanna“ – ISUL, Sofia, in the period 2014-2017. Results and discussion: Difficult intubation is observed in 8 patients (8%). Impossible intubation is observed in 12 patients (12%). The study showed that the major factor leading to difficult endotracheal intubation in patients with carcinoma of the larynx and hypopharynx is the laryngeal obstruction caused by the malignant process. Conclusion: difficult and impossible intubation rates in patients undergoing laryngectomies are higher than in the common population due to the obstruction caused by the carcinoma.