{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:43:59Z","timestamp":1786985039774,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Ventilation using 100% oxygenation creates a risk of fire during laser microlaryngeal surgery (MLS). The purpose of this study is to describe the technique of transnasal high\u2010flow ventilation using laser safe (30%) oxygen conditions, measure the intraoperative real\u2010time laryngeal oxygen concentration, and examine patient saturation status using this technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective IRB approved study of patients undergoing tubeless laser MLS using high\u2010flow nasal oxygenation. Delivered oxygen concentration was reduced from 100% to 30% before lasering using an oxygen\u2010air blender then increased to 100% post\u2010laser procedure. Outcome measures included time for laryngeal oxygen concentration to equalize to laser safe levels; time to, methods of and duration of rescue ventilation; and desaturation rates and apnoeic times at both 100% and 30% oxygen deliveries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty patients were recruited (mean age\u00a0=\u00a047.4\u2009years). Mean laryngeal oxygen concentration (%) at 100% and 30% deliveries was 98.46 and 31.45, respectively. Mean (SD) of laryngeal oxygen concentration equalization time to 30% (seconds) was 9.4 (3.69). At 30% oxygen delivery desaturation rate was faster and apneic time shorter compared with 100%. Eighteen patients required rescue (jet) ventilation and they had a faster apneic desaturation rate (%\/minute) than patients not requiring rescue. Mean (SD) apneic time (minutes) at 30% delivery was 4.56 (2.25) and 4.41 (2.18) in rescue versus non\u2010rescue groups respectively. BMI was the only significant predictor of desaturation rate at 30% oxygen delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is possible to achieve a safe time window for use of laser during MLS using transnasal humidified high\u2010flow ventilation by delivering 30% oxygen concentration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 133:634\u2013639, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30271","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T11:00:04Z","timestamp":1656673204000},"page":"634-639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Microlaryngeal Laser Surgery Using High\u2010flow Nasal Ventilation at Two Oxygen Concentration Deliveries"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3839-1353","authenticated-orcid":false,"given":"Daniel","family":"Novakovic","sequence":"first","affiliation":[{"name":"Voice Research Laboratory, Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Otolaryngology The Canterbury Hospital  Campsie New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3737-5984","authenticated-orcid":false,"given":"Meet","family":"Sheth","sequence":"additional","affiliation":[{"name":"Voice Research Laboratory, Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Otolaryngology Christian Medical College  Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avital","family":"Fellner","sequence":"additional","affiliation":[{"name":"Voice Research Laboratory, Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Zoszak","sequence":"additional","affiliation":[{"name":"Department of Anesthetics Wollongong Hospital  Wollongong New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Liew","sequence":"additional","affiliation":[{"name":"Department of Anesthetics Royal North Shore Hospital  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8097-8938","authenticated-orcid":false,"given":"Duy Duong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Voice Research Laboratory, Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Speech and Hearing National Hospital of Otorhinolaryngology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14215"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex036"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.06.011"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12923"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13873"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jbcr\/irz108"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2010.01.005"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2009.12.023"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000180215.50589.02"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.12.017"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew468"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/ajo.2019.07.02"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-021-00690-4"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-04636-3"},{"key":"e_1_2_7_16_1","unstructured":"Fisher & Paykel Healthcare. 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