Difficult airway management in a patient with a thin mandible
Identifieur interne : 000902 ( Main/Exploration ); précédent : 000901; suivant : 000903Difficult airway management in a patient with a thin mandible
Auteurs : Hong-Seok Choi [Corée du Sud] ; Jong-Shik Oh [Corée du Sud] ; Eun-Jung Kim [Corée du Sud] ; Ji-Young Yoon [Corée du Sud] ; Ji-Uk Yoon [Corée du Sud] ; Cheul-Hong Kim [Corée du Sud]Source :
- Journal of Dental Anesthesia and Pain Medicine [ 2383-9309 ] ; 2016.
Abstract
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur. Therefore, we used a fiberoptic bronchoscope to insert the NTT. After surgery, we performed a tongue-tie to protect against airway obstruction caused by the backward movement of the tongue during recovery. The patient recovered without any complications. We determined the status of the patient precisely and consequently performed thorough preparations for the surgery, allowing the patient to be anesthetized safely and recover after surgery. Careful assessment of the patient and airway prior to surgery is necessary.
Url:
DOI: 10.17245/jdapm.2016.16.4.317
PubMed: 28879322
PubMed Central: 5564199
Affiliations:
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management in a patient with a thin mandible</title><author><name sortKey="Choi, Hong Seok" sort="Choi, Hong Seok" uniqKey="Choi H" first="Hong-Seok" last="Choi">Hong-Seok Choi</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan</wicri:regionArea><wicri:noRegion>Yangsan</wicri:noRegion></affiliation></author><author><name sortKey="Oh, Jong Shik" sort="Oh, Jong Shik" uniqKey="Oh J" first="Jong-Shik" last="Oh">Jong-Shik Oh</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan</wicri:regionArea><wicri:noRegion>Yangsan</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Eun Jung" sort="Kim, Eun Jung" uniqKey="Kim E" first="Eun-Jung" last="Kim">Eun-Jung Kim</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan</wicri:regionArea><wicri:noRegion>Yangsan</wicri:noRegion></affiliation></author><author><name sortKey="Yoon, Ji Young" sort="Yoon, Ji Young" uniqKey="Yoon J" first="Ji-Young" last="Yoon">Ji-Young Yoon</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan</wicri:regionArea><wicri:noRegion>Yangsan</wicri:noRegion></affiliation></author><author><name sortKey="Yoon, Ji Uk" sort="Yoon, Ji Uk" uniqKey="Yoon J" first="Ji-Uk" last="Yoon">Ji-Uk Yoon</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan</wicri:regionArea><wicri:noRegion>Yangsan</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Cheul Hong" sort="Kim, Cheul Hong" uniqKey="Kim C" first="Cheul-Hong" last="Kim">Cheul-Hong Kim</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan</wicri:regionArea><wicri:noRegion>Yangsan</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Dental Anesthesia and Pain Medicine</title><idno type="ISSN">2383-9309</idno><idno type="eISSN">2383-9317</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur. Therefore, we used a fiberoptic bronchoscope to insert the NTT. After surgery, we performed a tongue-tie to protect against airway obstruction caused by the backward movement of the tongue during recovery. The patient recovered without any complications. We determined the status of the patient precisely and consequently performed thorough preparations for the surgery, allowing the patient to be anesthetized safely and recover after surgery. Careful assessment of the patient and airway prior to surgery is necessary.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Devlin, H" uniqKey="Devlin H">H Devlin</name></author><author><name sortKey="Ferguson, Mw" uniqKey="Ferguson M">MW Ferguson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klemetti, E" uniqKey="Klemetti E">E Klemetti</name></author><author><name sortKey="Vainio, P" uniqKey="Vainio P">P Vainio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sunanda, G" uniqKey="Sunanda G">G Sunanda</name></author><author><name sortKey="Rajesh, S" uniqKey="Rajesh S">S Rajesh</name></author><author><name sortKey="Dimpel, J" uniqKey="Dimpel J">J Dimpel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kollias, I" uniqKey="Kollias I">I Kollias</name></author><author><name sortKey="Krogstad, O" uniqKey="Krogstad O">O Krogstad</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnston, Cd" uniqKey="Johnston C">CD Johnston</name></author><author><name sortKey="Richardson, A" uniqKey="Richardson A">A Richardson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beresin, Ve" uniqKey="Beresin V">VE Beresin</name></author><author><name sortKey="Schiesser, Fj" uniqKey="Schiesser F">FJ Schiesser</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wright, Cr" uniqKey="Wright C">CR Wright</name></author><author><name sortKey="Muyskens, Jh" uniqKey="Muyskens J">JH Muyskens</name></author><author><name sortKey="Strong, Lh" uniqKey="Strong L">LH Strong</name></author><author><name sortKey="Westerman, Kn" uniqKey="Westerman K">KN Westerman</name></author><author><name sortKey="Kingery, Rh" uniqKey="Kingery R">RH Kingery</name></author><author><name sortKey="Williams, St" uniqKey="Williams S">ST Williams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Victor, Ld" uniqKey="Victor L">LD Victor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Murray, D" uniqKey="Murray D">D Murray</name></author><author><name sortKey="Dodds, C" uniqKey="Dodds C">C Dodds</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nayar, S" uniqKey="Nayar S">S Nayar</name></author><author><name sortKey="Knox, J" uniqKey="Knox J">J Knox</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Apfelgaum, Jl" uniqKey="Apfelgaum J">JL Apfelgaum</name></author><author><name sortKey="Haqberq, Ca" uniqKey="Haqberq C">CA Haqberq</name></author><author><name sortKey="Caplan, Ra" uniqKey="Caplan R">RA Caplan</name></author><author><name sortKey="Blitt, Cd" uniqKey="Blitt C">CD Blitt</name></author><author><name sortKey="Connis, Rt" uniqKey="Connis R">RT Connis</name></author><author><name sortKey="Nickinovich, Dg" uniqKey="Nickinovich D">DG Nickinovich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Parmet, Jl" uniqKey="Parmet J">JL Parmet</name></author><author><name sortKey="Colonna Romano, P" uniqKey="Colonna Romano P">P Colonna-Romano</name></author><author><name sortKey="Horrow, Jc" uniqKey="Horrow J">JC Horrow</name></author><author><name sortKey="Miller, F" uniqKey="Miller F">F Miller</name></author><author><name sortKey="Gonzales, J" uniqKey="Gonzales J">J Gonzales</name></author><author><name sortKey="Rosenberg, H" uniqKey="Rosenberg H">H Rosenberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Novak Jankovic, V" uniqKey="Novak Jankovic V">V Novak-Jankovic</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Choi, Hong Seok" sort="Choi, Hong Seok" uniqKey="Choi H" first="Hong-Seok" last="Choi">Hong-Seok Choi</name></noRegion><name sortKey="Kim, Cheul Hong" sort="Kim, Cheul Hong" uniqKey="Kim C" first="Cheul-Hong" last="Kim">Cheul-Hong Kim</name><name sortKey="Kim, Eun Jung" sort="Kim, Eun Jung" uniqKey="Kim E" first="Eun-Jung" last="Kim">Eun-Jung Kim</name><name sortKey="Oh, Jong Shik" sort="Oh, Jong Shik" uniqKey="Oh J" first="Jong-Shik" last="Oh">Jong-Shik Oh</name><name sortKey="Yoon, Ji Uk" sort="Yoon, Ji Uk" uniqKey="Yoon J" first="Ji-Uk" last="Yoon">Ji-Uk Yoon</name><name sortKey="Yoon, Ji Young" sort="Yoon, Ji Young" uniqKey="Yoon J" first="Ji-Young" last="Yoon">Ji-Young Yoon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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