{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T07:35:53Z","timestamp":1777620953434,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The objective of this study was to compare ventilation techniques utilized in microlaryngeal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two\u2010hundred surgeries performed from May 1, 2018 to March 1, 2020 and stratified as intubated, intermittently intubated (AAIV) or apneic. Patient demographics, comorbidities, anesthetic agents, intraoperative parameters\/events, and complications were studied and compared across the three groups using inferential analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median body mass index in the AAIV group was significantly higher (33 vs. 29; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0117). Median oxygen nadirs were lower in AAIV cases (81% vs. 91\u201392%) while CO<jats:sub>2<\/jats:sub> peak measurements were lower (33\u2009mmHg vs. 48\u2009mmHg) in the fully apneic cohort which were significantly shorter cases (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). CO<jats:sub>2<\/jats:sub> peak measurements were comparable between AAIV and intubated cohorts (median 48.5\u2009mmHg vs. 48.0\u2009mmHg). Median apnea times were significantly prolonged by 2\u20135.5\u2009minutes using nasal cannula and THRIVE\/Optiflow in fully apneic cases when compared to no supplementary oxygenation (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0013). Systolic blood pressures following insertion of laryngoscope were higher (159.5 vs. 145\u2009mmHg) and postoperative diastolic pressures were lower (68.5 vs. 76.5\u2009mmHg) in fully apneic cases than intubated cases. No differences existed between frequencies of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study compares intubated, intermittently apneic, and fully apneic surgeries. No statistically significant differences were noted in comorbid conditions. While intraoperative hemodynamic fluctuations were more pronounced in the fully apneic cohort, and oxygenation distributions were lower in the AAIV cohort, no significant differences existed between events and complications. Apneic techniques are as safe and effective as traditional intubation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2773\u20132781, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29750","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T12:23:42Z","timestamp":1627907022000},"page":"2773-2781","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["To Tube, or Not to Tube: Comparing Ventilation Techniques in Microlaryngeal Surgery"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4525-4920","authenticated-orcid":false,"given":"Mausumi N.","family":"Syamal","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery Lehigh Valley Health Network  Allentown Pennsylvania U.S.A."},{"name":"Department of Surgery, Division of Otolaryngology University of South Florida, Morsani School of Medicine  Tampa Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill","family":"Hanisak","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Lehigh Valley Health Network  Allentown Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Macfarlan","sequence":"additional","affiliation":[{"name":"Network Office of Research and Innovation Lehigh Valley Health Network  Allentown Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Briana","family":"Ortega","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology University of South Florida, Morsani School of Medicine  Tampa Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5146-6319","authenticated-orcid":false,"given":"Robert T.","family":"Sataloff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery and Lankenau Institute for Medical Research Drexel University College of Medicine  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1908-397X","authenticated-orcid":false,"given":"Michael S.","family":"Benninger","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197404000-00006"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-197711000-00007"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200601000-00010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.389"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-195911000-00007"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348946107000415"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198807000-00001"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199609000-00011"},{"key":"e_1_2_6_10_1","first-page":"863","article-title":"Apneic anesthesia in unventilated patients for various operations and explorations in laryngotracheal surgery","volume":"17","author":"Mak D","year":"1976","journal-title":"Ann Anesthesiol Fr"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197308000-00006"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29565"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14036"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12923"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489417744223"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199909000-00009"},{"key":"e_1_2_6_17_1","first-page":"S116","article-title":"Influence of apnoeic oxygenation in respiratory and circulatory system under general anaesthesia","volume":"6","author":"Kolettas A","year":"2014","journal-title":"J Thorac Dis"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005002"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14565"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex036"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0306-9877(82)90032-9"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.04.026"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1981.51.5.1287"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1985.59.5.1343"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14541"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15277"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12921"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197312000-00006"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28776"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.21037\/ajo.2019.05.02"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13408"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/59.3.295"},{"key":"e_1_2_6_33_1","article-title":"Hemodynamic changes following endotracheal intubation with glidescope(\u00ae) video\u2010laryngoscope in patients with untreated hypertension","volume":"3","author":"Dashti M","year":"2014","journal-title":"Res Cardiovasc Med"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.2344\/16-00014.1"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2010.59.2.116"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/1053-0770(94)90018-3"},{"key":"e_1_2_6_37_1","article-title":"Asystole following reintubation during suspension laryngoscopy","volume":"2012","author":"Glassman SH","year":"2012","journal-title":"Case Rep Anesthesiol"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29750","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29750","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T16:12:57Z","timestamp":1693239177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,2]]},"references-count":36,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/lary.29750"],"URL":"https:\/\/doi.org\/10.1002\/lary.29750","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,2]]},"assertion":[{"value":"2021-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}