Difficult airway management of a patient with limited range of motion in the temporomandibular joint and cervical extension caused by psoriatic arthritis: a case report

Maeda, Makishi; Chaki, Tomohiro; Kawaguchi, Ryoichi; Kimijima, Tomohiko; Yamakage, Michiaki

doi:10.1186/s40981-020-00351-6

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Among clinical findings, nine cases had limited mouth opening and seven had TMJ pain. The psoriasis manifestations were skin pigmentation, 14 plaque psoriasis on the scalp 15,19,20 on elbows, 21 rash on various parts of the skin, 22 dry mouth and eyes 23 or psoriasis vulgaris on different parts of the skin 24 . Seven cases reported involvement of other joints as well.…”

Section: Resultsmentioning

confidence: 99%

“…The psoriasis manifestations were skin pigmentation, 14 plaque psoriasis on the scalp 15,19,20 on elbows, 21 rash on various parts of the skin, 22 dry mouth and eyes 23 or psoriasis vulgaris on different parts of the skin. 24 Seven cases reported involvement of other joints as well. Blood tests revealed an elevated C-reactive protein level in two cases, 14,24 and a normal level in one case.…”

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

“…24 Seven cases reported involvement of other joints as well. Blood tests revealed an elevated C-reactive protein level in two cases, 14,24 and a normal level in one case. 23 A negative rheumatoid factor was found in three cases.…”

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

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Psoriatic arthritis of the temporomandibular joint: A systematic review

Almășan

Băciuţ

Buduru

et al. 2023

J of Oral Rehabilitation

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Objectives Psoriasis is an inflammatory condition brought on by the immune system. This study aimed to perform a systematic review related to psoriatic arthritis (PsA) of the temporomandibular joint (TMJ). Methods The search strategy was developed by a radiologist expert with more than 20 years of experience. The search was performed without time restrictions in five electronic databases: PubMed, Web of Science, Embase, Scopus and Ovid. The search strategy was based on MeSH and Emtree terms. The methodological quality of the studies was rated using the quality assessment tools from the National Heart Lung and Blood Institute (NHLBI). Results Twenty‐three publications were included, 10 being case reports. One hundred‐fifty‐one patients with TMJ PsA were reported. Psoriasis evolution ranged from 1.5 years to 24 years. Clinical symptoms of TMJ involvement included: TMJ pain and sounds, limited range of jaw movements, preauricular swelling, malocclusion, headache, tinnitus, neck stiffness and altered dietary function. TMJ was evaluated by magnetic resonance imaging (six studies), computed tomography (eight articles) and by ultrasonography findings (two articles). For TMJ treatment, topical and systemic medication was reported in 11 studies. Five studies included patients needing surgical procedures for TMJ ankylosis. Conclusions A relationship between TMD and psoriasis has been revealed. TMJ PsA has been investigated and debated, although the radiographic findings or clinical symptoms of PsA are not noticeably different from other forms of TMJ arthritis. Conservative therapy can lead to significant improvement of TMJ function.

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Section: Resultsmentioning

confidence: 99%

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

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Psoriatic arthritis of the temporomandibular joint: A systematic review

Almășan

Băciuţ

Buduru

et al. 2023

J of Oral Rehabilitation

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“…In this case, we tried to use the McGrath video laryngoscope with the fiberoptic intubation on standby. Several case reports demonstrated that fiberoptic bronchoscope-assisted intubation is a useful procedure both as a primary and as a rescue option for definitive airway management in various difficult airway cases (Hariharasudhan et al, 2016;Lim & Wong, 2019;Maeda et al, 2020;Pang et al, 2015;Sung et al, 2014). Sung et al reported a case of successful fiberoptic nasotracheal intubation in temporomandibular ankylosis with minimal mouth opening (Sung et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Difficult Airway Intubation Due to Mouth Opening Limitation Caused by Mandibular Abscess: A Case Report

Yuhono,

Jaya

2023

J.Ilm.Kedokt. Wijaya Kusuma

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Appropriate management of difficult airway is imperative, particularly in cases with anticipated difficult airway. It customarily requires deliberate perioperative assessment. In this article we present a case of limited mouth opening along with restricted mobility of the temporomandibular joint secondary to mandibular abscess which requires surgical intervention. Preoperatively, difficult airway intubation was expected (based on LEMON mnemonic on preoperative evaluation). Therefore, Macintosh video laryngoscope and fiberoptic bronchoscope was prepared to aid in intubation. Due to the patient’s anxiety towards the procedure, the intubation was done while the patient is asleep. Preoxygenation was uneventfully. Following induction with general anesthesia, several attempts to conduct nasotracheal intubation using Macintosh video laryngoscope were made but all were abortive. This failed attempt is primarily due to the limited mouth opening and jaw mobility. Hence, fiberoptic bronchoscope-assisted nasotracheal intubation was conducted and was able to achieve airway patency. In conclusion, preoperative management holds great importance in selecting airway management strategy. To add, fiberoptic bronchoscope-assisted intubation is a safe option for intubation

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“…The majority of anesthesiologists focus on the TMJ function evaluation as it relates to optimal intubating conditions [ 7 ]. Difficulties with intubation are especially common in patients with limited mouth opening such as those with TMJ ankyloses [ 8 , 9 , 10 , 11 ]. However, proper TMJ assessment is required both before and after anesthesia in order to avoid or minimize temporomandibular complications [ 6 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Temporomandibular Joint by Anesthetists in Florida When Conducting Orotracheal Intubation—A Pilot Study

Gadotti

Geronimo

Rodríguez

et al. 2020

JCM

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Background: Orotracheal intubation has been considered a risk factor for the development or exacerbation of disorders related to the temporomandibular joint (TMJ). The objective of this pilot study was to evaluate TMJ assessment performed by anesthetists in Florida when conducting orotracheal intubation. Methods: An online questionnaire was created using Qualtrics. The survey included 22 questions related to demographics, TMJ related to anesthesia procedures, and education/awareness regarding TMJ related to intubation. Descriptive statistics and cross-tabulation analysis were performed. Results: One hundred and eight providers participated (mean 46 years-old ± 12; 59% female). About 50% reported to always evaluate TMJ prior non-emergency intubation. Of those, 56% used an alternative intubation technique based on the TMJ status and 60% never/rarely evaluated TMJ post-intubation. Twenty-five percent reported they did not know of possible intubation effects on TMJ and 47% reported that they did not receive adequate information/education on TMJ management related to intubation in school. After participation, 81% reported to be more aware of the importance of evaluating TMJ. Conclusions: Only half of the providers who frequently performed intubation in Florida evaluated TMJ prior to intubation. This survey increased the awareness regarding the importance of evaluating TMJ when conducting intubation. This may contribute to reducing TMJ issues associated with non-emergency intubations.

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Difficult airway management of a patient with limited range of motion in the temporomandibular joint and cervical extension caused by psoriatic arthritis: a case report

Cited by 5 publications

References 13 publications

Psoriatic arthritis of the temporomandibular joint: A systematic review

Psoriatic arthritis of the temporomandibular joint: A systematic review

Difficult Airway Intubation Due to Mouth Opening Limitation Caused by Mandibular Abscess: A Case Report

Evaluation of Temporomandibular Joint by Anesthetists in Florida When Conducting Orotracheal Intubation—A Pilot Study

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