Analysis Of Related Factors Of Difficult Exposure Under Indirect Laryngoscope Laryngeal Cavity

Indirect laryngoscopy is the most commonly used otolaryngology head and neck surgery,the most economical and convenient method of examination and surgery to diagnose or microscopic hypopharyngeal foreign body,biopsy and even removal of the lower pharyngeal and laryngeal lesions such as epiglottis cyst Or vocal cord polyps and other treatment.Good hypopharyngeal exposure is conducive to the accurate diagnosis of hypopharyngeal diseases,is conducive to the smooth operation of the operation,is conducive to reducing intraoperative and postoperative complications.However,it is not uncommon for patients with hypopharyngeal hypopnea to be exposed.Therefore,the prediction of hypopharyngeal hypopnea is of paramount importance for the choice of surgical procedure and for its smooth progression.Objective:The study of indirect laryngoscopy examination of the common factors related to the exposure of the hypopharynx and pharynx,the exposure of the cavity has a certain degree of predictability,can assess the risk of surgery,is conducive to select the appropriate surgical approach is conducive to reducing intraoperative and postoperative complications,Thereby reducing the suffering of patients,reducing medical costs and saving medical resources for the country.Methods:A total of 300 ENT patients undergoing laryngeal surgery under indirect laryngoscopy between September 2015 and September 2017 were recruited.Among them,82 cases of vocal cord lesions(including larger vocal cord polyps,56 cases of vocal cord cysts,Tumor biopsy in 26 cases);Hypopharyngeal cavity foreign body 218 cases.The degree of exposure to hypopharyngeal cavity in each patient was assessed by the classification criteria for the exposure of the hypopharyngeal and pharynx to the hypopharyngeal cavity exposed group(experimental group n=79)and hypopharyngeal cavity exposed group(n=221)The gender,age,weight,height,height and body mass index(BMI),mouth opening,neck circumference,distance between the thyroid cartilage notch and mandibular submental angle(TMD),bite lip test,tongue back height)And other data,compared these data between the hypopharyngeal exposure group and the control group,screening X-ray examination,Mann Whitney rank sum test and logistic stepwise regression analysis to identify the risk of exposure to hypopharyngeal cavity under indirect laryngoscopy factor.Results:Three hundred patients were assigned to the Hypopharynx exposure group(n=79)and the hypopharyngeal cavity well exposed(n=221in the control group)according to established criteria.All data were statistically analyzed by X2 test or Mann Whitney rank sum test respectively.Among them,BMI,neck circumference,mouth opening degree,TMD,MMT and hysteromyopharyngeal cavity exposure were statistically significant(P<0.05)Bite labial experiment and hypopharyngeal cavity exposure is not statistically significant(P>0.05).Multivariate logistic regression analysis showed that BMI?25kg/m~2,neck circumference?40cm,mouth opening degree<4cm,TMD<6cm,MMT?3 level were independently related to the exposure of hypopharyngeal cavity.Conclusions:BMI,Neck circumference,Mouth opening,TMD,MMT,are the risk factors of indirect laryngoscope exposure difficulties.Combined with these factors,the exposure of indirect laryngoscope can be better predicted.