Difficult airway in patients with oral and maxillofacial surgery: case report

Authors

Jirawan Jirakijja

Publication Date

2005-01-01

Abstract

General anesthesia for patients undergoing surgery in the oral and maxillofacial region may be complicated. The anesthesiologist frequently faces the condition that makes mask ventilation and tracheal intubation potentially difficult. A careful preoperative airway assessment and proper preparation are essential for safe anesthesia. This is a report of two patients with different management of difficult airway problems. Case I: a 16-year-old man was scheduled for reconstruction of mandible with titanium reconstruction plate and iliac crest graft. His abnormal anatomic features were short, receding mandible and fixed tongue which were due to his previous operations. The airway was successfully secured with a fiberoptic-guided intubation under inhalation anesthesia. Case II: a 75-year-old woman presented with recent surgical removal of impaction and subsequently developed Ludwigûs angina. She was scheduled for incision and drainage under general anesthesia. The plan for airway management was initially to examine the patientûs airway by direct laryngoscopy under intravenous sedation. When sedatives was administered, the patient became unconscious and developed complete upper airway obstruction. It was impossible to ventilate the patient via a face mask resulting in desaturation and bradycardia. Emergency tracheostomy was performed. The surgery was carried out after stabilizing the patientûs condition. At the end of the procedure the patient was fully awake but exhibited respiratory insufficiency. She was transferred to the intensive care unit in the Police General Hospital where she developed cardiovascular complications. However, she was discharged home 2 months after admission without serious morbidity.

DOI

10.58837/CHULA.CUDJ.28.1.6

First Page

51

Last Page

58

Recommended Citation

Jirakijja, Jirawan (2005) "Difficult airway in patients with oral and maxillofacial surgery: case report," Chulalongkorn University Dental Journal: Vol. 28: Iss. 1, Article 6.
DOI: 10.58837/CHULA.CUDJ.28.1.6
Available at: https://digital.car.chula.ac.th/cudj/vol28/iss1/6