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A difficult airway is not more prevalent in patients suffering from spasmodic torticollis: a case series

[Les problèmes des voies aériennes ne sont pas plus fréquents chez les patients souffrant d’un torticolis spasmodique : une série]

Thien Bich Mac, MD^*, Francois Girard, MD FRCPC^*, Sylvie McKenty, MD FRCPC^*, Philippe Chouinard, MD FRCPC^*, Daniel Boudreault, MD FRCPC^*, Monique Ruel, RN^* and Guy Bouvier, MD FRCSC

^* From the Department of Anesthesiology and
The Neurosurgery Division, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Montréal, Québec, Canada.

Address correspondence to: Dr. François Girard, Department of Anesthesiology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke East, Montreal, Quebec H2L 4M1, Canada. Phone: 514-890-8000, ext. 26876; Fax: 514-412-7653; E-mail: francois.girard.chum{at}ssss.gouv.qc.ca

Purpose: We designed this retrospective study to assess the frequency of difficult airway and difficult intubation in patients with spasmodic torticollis and compare it to that of the general population.

Methods: After Institutional Review Board approval, data were collected from the charts of all the patients with spasmodic torticollis who underwent selective peripheral denervation at our institution between 1988 and 2001. The intubation grade was determined using the Cormack and Lehane laryngoscopic classification. The best laryngeal view was recorded.

Results: Data from 342 patients were available for analysis. Fourteen patients had a difficult airway. In two patients, intubation was difficult with three attempts at laryngoscopy in one patient and use of fibreoptic bronchoscopy in the other. Twelve (3.5%) patients presented with laryngoscopic grades of III or IV. The combined prevalence of laryngoscopic view grade III and IV and difficult intubation was 4.4%.

Conclusions: This study assesses the frequency of difficult intubation in patients suffering from spasmodic torticollis. When compared to the general population, these patients do not appear to have a higher frequency of difficult airway or difficult intubation.