{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:55:17Z","timestamp":1788576917760,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R25DC020706"],"award-info":[{"award-number":["R25DC020706"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002345"],"award-info":[{"award-number":["UL1 TR002345"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Microlaryngeal surgeries require unique considerations for airway management to facilitate patient safety and adequate surgical exposure. Small\u2010diameter endotracheal tubes (ETTs) are widely used but have raised concerns regarding patient safety, including questions about the potential for barotrauma, effective ventilation, and adequate oxygenation. We hypothesize that small ETTs will prove to be safe in a variety of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a case series analyzing the safety of 5.0 ETTs in microlaryngeal surgeries at Washington University School of Medicine from November 2020 to November 2023. Outcome measures included intraoperative desaturations (SpO<jats:sub>2<\/jats:sub>\u2009&lt;\u200990% for &gt;2\u2009min), high peak inspiratory pressures (PIPs) (&gt;40\u2009cm H<jats:sub>2<\/jats:sub>O), and prolonged extubation times (&gt;15\u2009min). Univariate regression models were used to analyze associations of sociodemographic and clinical variables with these outcome measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 76 small\u2010ETT microlaryngeal surgeries. There were 5 instances of desaturations, no reported incidents of barotrauma, and no cases in which intraoperative tube exchange was required due to issues with oxygenation or ventilation. Median PIP was 38\u2009cm H<jats:sub>2<\/jats:sub>O, with a range of 17\u201378\u2009cm H<jats:sub>2<\/jats:sub>O. 46% of patients had a PIP above 40\u2009cm H<jats:sub>2<\/jats:sub>O. There were prolonged extubation times in 14% of procedures. No association was shown between sociodemographic and clinical variables with risk of desaturations, high PIPs, or prolonged extubation times.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that 5.0 ETTs are safe for microlaryngeal surgery in a variety of patients. Otolaryngologists and anesthesiologists should consider this information when choosing between the multiple available options for airway management during microlaryngeal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 135:1451\u20131454, 2025<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31865","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T10:49:28Z","timestamp":1730371768000},"page":"1451-1454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety of Small\u2010Diameter Endotracheal Tubes in Microlaryngeal Surgery"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6840-6283","authenticated-orcid":false,"given":"William A.","family":"Strober","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Washington University School of Medicine in St Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5973-9027","authenticated-orcid":false,"given":"Kwasi","family":"Enin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Washington University School of Medicine in St Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorina","family":"Kallogjeri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Washington University School of Medicine in St Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay F.","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Washington University School of Medicine in St Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Komen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Washington University School of Medicine in St Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Rohlfing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Washington University School of Medicine in St Louis  St Louis Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.324"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28776"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221512200024X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s44158-022-00066-3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000000786"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13438"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29750"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.1198"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2016.01.029"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21168"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2004.04.003"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0704(05)70266-9"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00420103"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001316"},{"key":"e_1_2_7_16_1","first-page":"1020","article-title":"Perioperative desaturation and risk factors in general anesthesia","volume":"91","author":"Uakritdathikarn T","year":"2008","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_7_17_1","first-page":"467","article-title":"The incidence of desaturation during anesthesia in adult and pediatric patients: a retrospective study","volume":"72","author":"Vika Fatafehi Hala'ufia L","year":"2018","journal-title":"Acta Med Okayama"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)00057-6"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09170"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31865","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T04:24:48Z","timestamp":1741839888000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,31]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/lary.31865"],"URL":"https:\/\/doi.org\/10.1002\/lary.31865","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,31]]},"assertion":[{"value":"2024-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}