Background: At present, there is a paucity of data in the literature pertaining to the impact of radiotherapy (RT) on the success of tracheal intubation in patients with nasopharyngeal cancer (NPC). The aim of this study is to investigate the frequency of difficult tracheal intubation in patients with NPC following RT.Methods: Patients with NPC who underwent RT followed by surgery between 2012 and April 2024 at the University Hospital Heidelberg were retrospectively analyzed.Results: Twenty-three patients, predominantly males (73.9%) with a mean age of 52.9 years, were enrolled. Overall, 65.2% of the patients had an American Society of Anesthesiologists (ASA) class of III. The mean total laryngeal dose was 53.5 Gy for the main and boost plan, and the maximum total laryngeal dose was 66.61 Gy. Direct laryngoscopy was performed in 69.6% of cases, followed by 26.1% videolaryngoscopy, and 4.2% required fiberoptic intubation. In total, 47.8% of the patients had a Cormack/Lehane grade of I, followed by 43.5% with grade II and 8.7% with grade III. Overall, 87% of patients were successfully intubated on the first attempt.Conclusions: It has been demonstrated by previous studies that RT has the potential to enhance complications and difficulties encountered during airway management. While the results must be interpreted with caution, our study provides no evidence of severe impairment in advanced airway management in patients with nasopharyngeal cancer who have undergone radiotherapy.
背景：目前，关于放疗对鼻咽癌患者气管插管成功率影响的文献数据较为匮乏。本研究旨在探讨鼻咽癌患者放疗后气管插管困难的发生频率。 方法：本研究回顾性分析了2012年至2024年4月期间在海德堡大学医院接受放疗后手术的鼻咽癌患者。 结果：共纳入23例患者，其中男性占主导地位（73.9%），平均年龄为52.9岁。总体而言，65.2%的患者美国麻醉医师协会分级为III级。主计划和加强计划的平均喉部总照射剂量为53.5 Gy，最大喉部总照射剂量为66.61 Gy。69.6%的病例采用直接喉镜插管，26.1%采用视频喉镜插管，4.2%需要纤维支气管镜引导插管。总体而言，47.8%的患者Cormack/Lehane分级为I级，43.5%为II级，8.7%为III级。87%的患者首次尝试插管成功。 结论：既往研究表明，放疗可能增加气道管理过程中的并发症和困难。尽管研究结果需谨慎解读，但本研究未发现放疗后鼻咽癌患者在高级气道管理方面存在严重障碍的证据。
Radiotherapy Effects on Airway Management in Patients with Nasopharyngeal Cancer
肿瘤(癌症)患者之家