• Lasers Surg Med · Jan 2003

    Value of endotracheal tube safety in laryngeal laser surgery.

    • Andreas M Sesterhenn, Anja-A Dünne, Daniel Braulke, Burkard M Lippert, Benedikt J Folz, and Jochen A Werner.
    • Department of Otolaryngology, Head and Neck Surgery, University of Marburg, D-35037 Marburg, Germany.
    • Lasers Surg Med. 2003 Jan 1;32(5):384-90.

    Background And ObjectivesDue to the increased popularity of laryngeal laser therapy, surgeons and anesthesiologists are inevitably confronted with questions concerning the choice of the most efficient endotracheal tube (ETT) for laryngeal laser surgery, especially with regard to possible endolaryngeal tube fires, or combustions. The purpose of this study was to determine the current practice in endolaryngeal laser surgery in Germany.Study Design/Materials And MethodsA questionnaire was sent to 152 ENT Departments in Germany, care was taken that the responders could send back the questionnaire anonymously. Among other questions the participants were asked for the number of lasersurgical treatments of the larynx performed in the past, the usual type of ETTs in use, whether other safety precautions were taken during CO2 laser surgery of the larynx and for intraoperative complications like tube ignition, fires or combustions.ResultsEighty six of the 152 addressed ENT departments replied. In laryngeal laser surgery, 59/86 departments regularly use special laser tubes in daily routine (74.5%). In about 20,000 lasersurgical procedures, 15 incidents of ETT fire have been reported. In six of the reported 15 cases a tube fire occurred despite the fact that special laser tubes had been utilized.ConclusionsThe present study could demonstrate that the use of special laser tubes does not necessarily protect against ETT fire. Thus, even when using special laser tubes other safety measures should be taken. In view of the maximum safety for the patient it has to be stated, that the safety during surgery correlates definitely with the experience of the surgeon. The weakest point of ETTs is usually situated in the cuff region.Copyright 2003 Wiley-Liss, Inc.

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