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Value of endotracheal tube safety in laryngeal laser surgery
Author(s) -
Sesterhenn Andreas M.,
Dünne AnjaA.,
Braulke Daniel,
Lippert Burkard M.,
Folz Benedikt J.,
Werner Jochen A.
Publication year - 2003
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.10174
Subject(s) - endotracheal tube , medicine , laser surgery , larynx , surgery , laser safety , intubation , laser , general surgery , physics , optics
Background and Objectives Due 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 Methods A 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 CO 2 laser surgery of the larynx and for intraoperative complications like tube ignition, fires or combustions. Results Eighty 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. Conclusions The 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. Lasers Surg. Med. 32:384–390, 2003. © 2003 Wiley‐Liss, Inc.