外科ジャーナル

Relationship of the Shape of Epiglottis and the Endotracheal Intubation

Abstract

Hiroyuki Nakao

Background and Purpose: Surgeons may encounter rare cases of difficult intubation. It is known the Cormack and Lehane grading as the prediction method of the intubation difficulty. However, the shape of the epiglottis greatly affects the visible range of the vocal cords. We report a classification of the shape of the epiglottis and the relationship between the shape and the grading.
Target and Method: By observation at their laryngeal expansion at tracheal intubation for 181 adult thyroid patients undergoing surgery, it was estimated the shape of the epiglottis and the grading.
Result: The shapes of the epiglottis were classified into five types. The classification of the shape was possible to know the difficulty of intubation and the frequency based on the grading. If the risk of intubation was recognized the shape, it was possible to infer immediately without the larynx expansion.
Discussion: The three axes theory for the easy intubation has been explained. If the three axes are close to parallel, the success of the tracheal intubation is depending on the shape of the epiglottis. There has been no discussion about the shape of the epiglottis that makes it difficult to see the vocal cords until now.
Many have been reported the intubation of children to be difficult because of the shape of the epiglottis. This study for adults is consistent with the cases of children. Many new safe and easy tools for difficult intubation are easily not considered the influence of the shape of the epiglottis.
Conclusion: Syphilis seropositive cases were observed among married women who come from a rural area with the age group of 26-35 years. Therefore, health education on etiology, prevention, and control of syphilis has to be provided for the community.