gms | German Medical Science

82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

01.06. - 05.06.2011, Freiburg

Standardizing the diagnosis of inhalation injury: A simple scoringS system based on a joint ENT-ICU approach

Meeting Abstract

  • corresponding author Florian J. W. Lang - Clinique d`ORL, Hop. Cantonal, Fribourg, Schweiz
  • C. Ikonomidis - ENT Clinic, Lausanne, Schweiz
  • A. Radu - ENT Clinic, Lausanne, Schweiz
  • M. M. Berger - Adult Intensive Care Clinic, CHUV, Lausanne, Schweiz

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Freiburg i. Br., 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hnod034

doi: 10.3205/11hnod034, urn:nbn:de:0183-11hnod0346

Published: April 19, 2011

© 2011 Lang et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Inhalation injury is an important determinant of outcome in patients with major burns. However diagnostic criteria remain imprecise, which prevents comparisons of published data and analysis of the impact of inhalation injury on outcome. The study aims to evaluate the applicability of an inhalation score based on mucosal caustic injury diagnosis. It includes separate assessment of the oro-pharyngeal sphere (ENT) and tracheobronchial tree (TB) in burn patients admitted to the ICU with a suspicion of inhalation injury.

Methods: Prospective observational study in 168 patients admitted to the burn-ICU of a university teaching hospital. One hundred patients suspect of inhalation injury underwent an endoscopic airway assessment. ENT/TB lesion grading was 1. edema, hyperemia, hypersecretion, 2. bullous mucosal detachment, erosion, exudates, 3. profound ulcers, necrosis.

Results: Of the 100 examined patients (age 42±17y, burns 23±19% BSA), 79 patients presented an ENT inhalation injury >ENT1 (soot present in 24%): 36 had a tracheo-bronchial extension, 33 having a grade >TB1. Ten patients without burned vibrissae suffered an ENT inhalation injury suggesting that burned vibrissae are not a reliable sign for inhalation injury. Length of mechanical ventilation was significantly correlated with the presence of inhalation injury (p=0.03).

Conclusions: This new inhalation injury score was directly applicable and simple to use in daily management of burn patients, providing a unified language between the different specialists involved. A first prognostic impact could be demonstrated. Further multicentric studies are required to validate the score.