Current Perspectives in Intra Operative Airway Management in Maxillofacial Trauma

Vidya, B; Cariappa, K. M.; Kamath, Abhay Taranath

doi:10.1007/s12663-011-0316-8

Cited by 13 publications

(15 citation statements)

References 18 publications

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“…32 Contraindication to this technique includes skull base fractures. 33 Both anesthesiologists and otolaryngologists are trained in this technique.…”

Section: Techniquesmentioning

confidence: 99%

Integration of a Difficult Airway Response Team into a Hospital Emergency Response System

Chmielewska

Winters

Pandian

et al. 2015

Anesthesiology Clinics

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“…32 Contraindication to this technique includes skull base fractures. 33 Both anesthesiologists and otolaryngologists are trained in this technique.…”

Section: Techniquesmentioning

confidence: 99%

Integration of a Difficult Airway Response Team into a Hospital Emergency Response System

Chmielewska

Winters

Pandian

et al. 2015

Anesthesiology Clinics

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“…Once initial airway management has secured oxygenation, it may become necessary to change to a different ventilation mode for surgical procedures pre-or intraoperatively. 26,42 Changing from a nasal to an oral tube or vice versa is equally feasible. 26,43 The authors strongly advise proceeding under visual control, avoiding blind placement and protrusion of instruments and endotracheal tubes.…”

Section: Intraoperative Airway Management Indicationsmentioning

confidence: 99%

Airway Management in Facial Trauma Patients

Jacomet

Tasman

2015

Facial plast Surg

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Airway management in craniofacial trauma patients is a challenge for an anesthetist. Treating these patients requires a close interdisciplinary communication and cooperation. Maintaining the airway and oxygenation of the patient is the initial challenge in craniofacial trauma patients. The management of the difficult airway is facilitated and patient's safety improved by following one of several published difficult airway algorithms. We describe the St. Gallen difficult airway algorithm for the management of difficult airway in general and the airway in facial trauma patients in particular. Whenever possible, the airway should be secured in a conscious and spontaneously breathing patient. It is important to be familiar with different techniques and to change the approach after two unsuccessful attempts with one technique. Once the airway is established, all available preventive measures should be used to avoid losing the airway. A tracheotomy has its place in a significant number of patients in whom an immediate postoperative or a delayed extubation appears unfeasible.

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“…However, if necessary, a tracheal tube smaller than the standard size can be used for retromolar intubation. Some authors have described concurrent third molar extraction and bone removal by semilunar osteotomy in the region to enable retromolar intubation, although the latter method seems to add further morbidity to a technique designed to avoid it [17]. Destruction of bony anatomy for the sole purpose of making space for an endotracheal tube passage does not make sense, especially when the bone may be useful for fracture segment fixation devices [16].…”

Section: Orotracheal Intubation-retrotuberosity/retromolarmentioning

confidence: 99%

Intubation Techniques: Preferences of Maxillofacial Trauma Surgeons

Jaisani

Pradhan

Bhattarai

et al. 2014

J. Maxillofac. Oral Surg.

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Objective To evaluate the clinical outcomes of alternative techniques of intubation in patients sustaining maxillofacial injuries, where nasotracheal intubation (NTI) is best avoided. Material and Methods Alternative techniques to standard naso-tracheal intubation like submental intubation, orotracheal intubation-retrotuberosity/retromolar and missing dentition were used and variables of clinical outcome recorded.Results Submental intubation provides an unobstructed intraoral surgical field, avoids intraoperative and postoperative complications of tracheostomy, and overcomes the disadvantages of NTI. In our experience with submental intubation (6 cases), we only had complication related to tube apparatus like damage to pilot balloon. With retrotuberosity intubation (5 cases) we did not encounter any complications and the only limitations were bulbous maxillary tuberosity. Retromolar intubation (4 cases) a safe noninvasive technique has disadvantages like tube interference within the surgical field and not feasible in case of limited retromolar space. Orotracheal-missing dentition intubation (4 cases) is of great advantage i.e. it can be used in cases where NTI is contraindicated, no specialized skill required, no added cost, avoids the need for tracheostomy, no extra-oral procedures required and does not interfere with occlusion/MMF; with disadvantage of occasional tube interference within the surgical field. Conclusion Preferred techniques of securing an airway like orotracheal, nasotracheal may not always be applicable, thus a trauma surgeon-anesthesist team should always have alternative techniques in their armamentarium to reduce the morbidity associated with these patients without interference with occlusion, which is prime goal in jaw fracture reduction. We have used these techniques in a country with limited resources and found them equally effective and convenient to use.

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Current Perspectives in Intra Operative Airway Management in Maxillofacial Trauma

Abstract: Intubation of any form performed in a maxillofacial trauma patient is complex and requires both sound judgement and considerable experience.

Cited by 13 publications

References 18 publications

Integration of a Difficult Airway Response Team into a Hospital Emergency Response System

Integration of a Difficult Airway Response Team into a Hospital Emergency Response System

Airway Management in Facial Trauma Patients

Intubation Techniques: Preferences of Maxillofacial Trauma Surgeons

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