Transoral Laser Microlaryngeal Surgery with MLT Tubes: A Retrospective Case Series.

Abstract

To evaluate effectiveness of using MLT tubes for transoral laser MLS in terms of surgical visualization, complete excision of vocal cord lesions, maintenance of adequate oxygenation and ventilation and the occurrence of any airway related complications. In a retrospective case series study, review of electronic medical records was conducted for 64 patients who underwent transoral laser MLS over an 18-month period. The collected data included vital parameters, mode of ventilation, ET tube details, surgical field of vision, perioperative adverse events and postoperative ventilation requirements. Among the 64 patients, 82.8% of the time, 5 size MLT tubes were used, fixed at meanlengths of21.6cm in females and 23.07cm in males respectively. A good surgical field of exposure was achieved in 92.2% of patients, with an average FiO2 of 0.29 during laser useand pressure control ventilation mode being the majority choice. 98.4% were extubated on table. The incidence of cuff rupture and bronchospasm was 4.7% and 1.6% respectively with no instances attributable to laser relatedevents. Even though Laser resistant tubes are considered gold standard, MLT tubes can be used by taking adequate precautions to reduce Laser related complications when there is limited availability of laser tubes. Level of evidence Case series.