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Endotracheal intubation was performed successfully in 1902 patients (99.3%), but in 52 of these patients direct laryngoscopy was difficult, primarily due to impairment of mouth opening. Fifteen of the 52 patients in whom direct laryngoscopy was difficult did not have any pre-existing conditions such as impairment of mouth opening, retrognathia or micrognathia.From the standpoint of anesthetic management, it is very important to find a method that will allow us to predict the difficulty of direct laryngoscopy during endotracheal intubation.This study cephalometrically analyzed the craniofacial morphological features of patients in whom direct laryngoscopy was difficult to identify parameters for predicting the relative difficulty of direct laryngoscopy. Thirteen of the aforementioned 15 patients, complete with materials were studied.The results of this study show that the most significant factor in determining the difficulty of direct laryngoscopy was the\"depth\"of the epiglottic vallecula and the arytenoid cartilage of the airway.Lower facial height was found to be an effective parameter as well.Concerning the\"depth\"of the epiglottic vallecula I found that the critical point for difficulty in direct laryngoscopy was a distance of more than 73 mm between the most forward point of the tuberculum anterius atlantis and the epiglottic vallecula with a specificity of 97.1%. The distance between the most forward point of the tuberculum anterius atlantis and the most superior point of the arytenoid cartilage was found to be a useful landmark.In conclusion, the results of this study suggest that the\"depth\"of the epiglottic vallecula measured by cephalometric head films is a quantitative criterion for identifying patients who have a high risk of difficulty in direct laryngoscopy during endotracheal intubation.", "subitem_description_type": "Abstract"}]}, "item_4_description_41": {"attribute_name": "資源タイプ", "attribute_value_mlt": [{"subitem_description": "紀要類(bulletin)", "subitem_description_type": "Other"}]}, "item_4_description_66": {"attribute_name": "フォーマット", "attribute_value_mlt": [{"subitem_description": "1193919 bytes", "subitem_description_type": "Other"}]}, "item_4_description_81": {"attribute_name": "dc.description.provenance", "attribute_value_mlt": [{"subitem_description": "Made available in DSpace on 2008-05-02T05:55:11Z (GMT). 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<原著>喉頭直達鏡による気管内挿管時の喉頭展開の難易に関する研究
http://hdl.handle.net/10097/31478
http://hdl.handle.net/10097/31478347595fc-0187-4ead-8f4e-ad99f545d70e
名前 / ファイル | ライセンス | アクション |
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KJ00000093498.pdf (1.2 MB)
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Item type | 紀要論文 / Departmental Bulletin Paper(1) | |||||
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公開日 | 2008-05-02 | |||||
タイトル | ||||||
タイトル | <原著>喉頭直達鏡による気管内挿管時の喉頭展開の難易に関する研究 | |||||
言語 | ||||||
言語 | jpn | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | direct laryngoscopy | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | epiglottic vallecula | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | arytenoid cartilage | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | endotracheal intubation | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | cephalometric head film | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | departmental bulletin paper | |||||
著者 |
普天間, 朝議
× 普天間, 朝議 |
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著者(ヨミ) | ||||||
姓名 | Futenma, Chogi | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 東北大学歯学部附属病院で8年3か月間に麻酔管理を行った1916例のうち1902例(99.3%)に気管内麻酔が行われた。この1902例中, 喉頭展開が困難であった症例は52例(2.7%)で, その原因としては開口障害が26例と最も多かった。しかし, 開口障害や下顎の後退, 小下顎症など喉頭展開を困難にする明らかな要因が認められなかったにもかかわらず喉頭展開が困難であった症例を15例経験した。従って, このような症例の気管内挿管に際し, 喉頭展開の難易を予測することは麻酔管理上, 極めて重要である。そこで本研究では, この15例中資料の整っていた13例を対象に, 喉頭展開を困難にする解剖学的要因について, 側面頭部X線規格写真を用いて検討した。その結果, 喉頭展開が困難であった症例では, 容易であった症例に比べて喉頭蓋谷及び被裂軟骨部が気道のより"深い"位置にあることが判明した。また下顔面高も喉頭展開を困難にする要因の1つと考えられた。喉頭展開困難を予測する指標としては第1頚椎前結節最前点一喉頭蓋谷間距離73mm以上が特異度97.1%で最も有用であった。また第1頚椎前結節最前点一被裂軟骨部最上点間距離94mm以上も感度83.3%, 特異度86.2%で有用な指標であることが示唆された。本研究の結果から, 側面頭部X線規格写真を用いて喉頭蓋谷の深さを計測することは気管内挿管時の喉頭展開困難症例を予測できる有用な評価方法であると考えられた。 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | A total of 1916 patients underwent general anesthesia at Tohoku University Dental Hospital over the past 8 years. Endotracheal intubation was performed successfully in 1902 patients (99.3%), but in 52 of these patients direct laryngoscopy was difficult, primarily due to impairment of mouth opening. Fifteen of the 52 patients in whom direct laryngoscopy was difficult did not have any pre-existing conditions such as impairment of mouth opening, retrognathia or micrognathia.From the standpoint of anesthetic management, it is very important to find a method that will allow us to predict the difficulty of direct laryngoscopy during endotracheal intubation.This study cephalometrically analyzed the craniofacial morphological features of patients in whom direct laryngoscopy was difficult to identify parameters for predicting the relative difficulty of direct laryngoscopy. Thirteen of the aforementioned 15 patients, complete with materials were studied.The results of this study show that the most significant factor in determining the difficulty of direct laryngoscopy was the"depth"of the epiglottic vallecula and the arytenoid cartilage of the airway.Lower facial height was found to be an effective parameter as well.Concerning the"depth"of the epiglottic vallecula I found that the critical point for difficulty in direct laryngoscopy was a distance of more than 73 mm between the most forward point of the tuberculum anterius atlantis and the epiglottic vallecula with a specificity of 97.1%. The distance between the most forward point of the tuberculum anterius atlantis and the most superior point of the arytenoid cartilage was found to be a useful landmark.In conclusion, the results of this study suggest that the"depth"of the epiglottic vallecula measured by cephalometric head films is a quantitative criterion for identifying patients who have a high risk of difficulty in direct laryngoscopy during endotracheal intubation. | |||||
書誌情報 |
東北大学歯学雑誌 巻 13, 号 2, p. 73-86, 発行日 1994-12-28 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 02873915 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AN00081101 | |||||
フォーマット | ||||||
内容記述タイプ | Other | |||||
内容記述 | application/pdf | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
その他の言語のタイトル | ||||||
その他のタイトル | A study of the ease or difficulty of direct laryngoscopy with the laryngoscope for endotracheal intubation | |||||
出版者 | ||||||
出版者 | 東北大学歯学会 | |||||
資源タイプ | ||||||
内容記述タイプ | Other | |||||
内容記述 | 紀要類(bulletin) | |||||
登録日 | ||||||
日付 | 2008-05-02 | |||||
日付タイプ | Created | |||||
公開日(投稿完了日) | ||||||
日付 | 2008-05-02 | |||||
日付タイプ | Created | |||||
発行日 | ||||||
日付 | 1994-12-28 | |||||
日付タイプ | Created | |||||
フォーマット | ||||||
内容記述タイプ | Other | |||||
内容記述 | 1193919 bytes | |||||
公開範囲 | ||||||
値 | 学外 | |||||
更新日 | ||||||
日付 | 2010-01-27 | |||||
日付タイプ | Created |