Soft tissue injuries after direct laryngoscopy

•Our study aimed to study minor injuries to soft tissues after laryngoscopy.•Oral injury was observed in 52.1% patients where all the lesions were grade I or II.•Trauma was most common in the tongue (36.3%) followed by the lower lip 22.3%.•Grade 1 lesions were higher in the tongue and lower lip, wheres grade 2 lesions were higher in the upper lip and mucosa.•Other airway devices must be compared concerning minor airway injuries.

Study objectiveThe study objective is to determine the incidence of oral soft tissue trauma during classic direct laryngoscopy for tracheal intubation and the risk factors associated with it.DesignThis is a prospective observational study.SettingThe setting is at a ward.PatientsThe patients are adults submitted to elective interventions in general surgery requiring tracheal intubation by classic direct laryngoscopy.InterventionsDuring 6 months, all patients were interviewed 12-24 hours before anesthesia and after surgery and underwent a detailed oral examination performed by an anesthesiology blind to anesthetic management details and preoperative patient care.MeasurementsEvaluation of oral soft tissue injuries includes oral mucosa including the gums; the alveolar mucosa in the edentulous patient, palate, and the buccal mucosa; lips (mucosa and skin); and the tongue. Injury severity was assessed using the severity scale presented routinely in Portuguese legal medicine research: grade 0, no injuries had; grade 1, mild severity injuries; grade 2, medium severity injuries; and grade 3, major severity injuries.Main resultsSoft tissue trauma was observed in 278 (52.1%) patients. Soft tissue injury occurred once in 204 (38.2%) patients, 2 in 64 (38.2%) patients, and 3 times in 10 (1.9%) patients. Tongue injury was the most common type of soft tissue trauma (36.3%) followed by lower lip injury (22.3%), upper lip injury (7.1%), and oral mucosa injury (2.1%). All the lesions were grade 1 or 2. Only oral mucosa injury was found to be associated with age group (P = .021).ConclusionsOur study reveals a high incidence of lesions grade 1 or 2 in soft tissue.