Complication Rates
There were no episodes of major cardiorespiratory instability related to SL itself, although one patient suffered a short but major drop in oxygen saturations in response to the apneic period during subglottic balloon dilatation. 4 further patients required temporary intraoperative intubation to allow positive pressure ventilation and recruitment maneuvers as SJV alone was insufficient to maintain oxygen saturations; all patients were successfully extubated post-procedure. No other major complications were encountered over this data collection period.
The rates of minor complications associated with SL are shown in Table 3. The most common complication was that of a temporary sore throat without significant dysphagia (66%), which universally resolved by the third postoperative day. On multivariate analysis, the incidence of sore throat was negatively correlated with interincisor gap (r=-0.186, p=0.023) – although interincisor gap was also negatively correlated with age (r=-0.2, p=0.014), no significant direct correlation was found between age and sore throat. Tongue symptoms occurred in 10 cases (6.7%), all of which were mild and temporary sensory disturbances. These positively correlated with macroglossia on multivariate analysis (r=0.452, p=1.611x10-8). No incidences of tongue weakness occurred in our cohort. Oropharyngeal trauma occurred in 4 patients (2.7%) – these were mild in all cases. Dental and temporomandibular joint pain were reported in a further 2 cases, both of which were exacerbations of pre-existing symptoms on further questioning. There were no incidences of dental loosening or injury. Despite correlations with poor grades of view, the chosen markers for unfavorable patient body habitus did not significantly correlate with increases in complications. No other statistically significant correlations between patient or procedural factors and complications were identified.