Airway management of patients undergoing oral cancer surgery

Mishra, Seema; Bhatnagar, Sushma; Jha, Rajeev Ranjan; Singhal, Amit

doi:10.1017/s0265021505000876

Cited by 54 publications

(32 citation statements)

References 17 publications

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“…Airway management is crucial for oromaxillofacial surgery patients that undergo sugery for severe oral disease and management may be difficult for the operating surgeon17. Therefore, recently, overnight intubation with an endotracheal tube has been introduced for cases in which challenging airway maintenance is predicted such as in postoperative edema18,19.…”

Section: Discussionmentioning

confidence: 99%

Elective tracheostomy scoring system for severe oral disease patients

Kim

2014

J Korean Assoc Oral Maxillofac Surg

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ObjectivesThe purpose of this research was to create a scoring system that provides comprehensive assessment of patients with oromaxillofacial cancer or odontogenic infection, and to statistically reevaluate the results in order to provide specific criteria for elective tracheostomy.Materials and MethodsAll patients that had oral cancer surgery (group A) or odontogenic infection surgery (group B) during a period of 10 years (2003 to 2013) were subgrouped according to whether or not the patient received a tracheostomy. After a random sampling (group A: total of 56, group B: total of 60), evaulation procedures were observed based on the group classifications. For group A, four factors were evaluated: TNM stage, reconstruction methods, presence of pathologic findings on chest posterior-anterior (PA), and the number of systemic diseases. Scores were given to each item based on the scoring system suggested in this research and the scores were added together. Similarly, the sum score of group B was counted using 5 categories, including infection site, C-reactive protein level on first visit, age, presence of pathologic findings on chest PA, and number of systemic diseases.ResultsThe scoring system rendered from this research shows that there is a high correlation between the scores and TNM stage in oral cancer patients, or infection sites in odontogenic infection patients. However, no correlation between pathologic findings on chest PA could be found in either group. The results also indicated that for both groups, the hospital day increased with the tracheostomy score. The tracheostomy score cutoff value was 5 in oral cancer patients and 6 in odontogenic infection patients which was used for elective tracheostomy indication.ConclusionThe elective tracheostomy score system suggested by this research is a method that considers both the surgical and general conditions of the patient, and can be very useful for managing patients with severe oral disease.

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Section: Discussionmentioning

confidence: 99%

Elective tracheostomy scoring system for severe oral disease patients

Kim

2014

J Korean Assoc Oral Maxillofac Surg

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“…Tracheal intubations in patients with limited neck extension and mouth opening due to reasons including previous radiation therapy in the head and neck area, otorhinolaryngeal disease or cervical spine pathology are challenging [1,2]. Awake fibreoptic intubation is regarded as a standard practice in an anticipated difficult airway; however, it needs extensive training and is time-consuming [3].…”

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confidence: 99%

Comparison of tracheal intubation with the Airway Scope or Clarus Video System in patients with cervical collars

Kim

et al. 2011

Anaesthesia

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SummaryTracheal intubations with the Airway Scope or the Clarus Video System, a new rigid fibrescope, were compared in 140 patients whose necks were immobilised by cervical collars. The time for intubation, success rate, number of attempts and number of optimisation manoeuvres were assessed. Mean (SD) intubation time was longer with the Airway Scope (30.4 (16.5) s) than with the Clarus Video System (18.9 (15.2) s; p = 0.003) and the median (IQR [range]) number of optimisation manoeuvres was also marginally different; 0 (0-1 [0-2]) with the Airway Scope, 0 (0-0 [0-2]) with the Clarus Video System; p = 0.004. The tracheas of 67 (95.7%) and 66 (94.3%) patients were successfully intubated with the Airway Scope and the Clarus Video System, respectively (p = 1.0). The number of attempts, vital signs and complications were not different between devices. The Clarus Video System was comparable to the Airway Scope in the success rate for tracheal intubation, but provided faster and easier intubations than the Airway Scope in patients with cervical collars.

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“…24 The proportion of intubations which met our quality requirements ( 2 attempts, duration < 180 s and Fahey scale < 2) was 78.8%. These quality requirements (defined according to the literature 10 and our clinical experience) were strictly adhered to in ENT cancer patients for whom intubation was predicted to be difficult, and were met in a high proportion of cases (26 out of 33).…”

Section: Discussionmentioning

confidence: 83%