Difficult airway management in a patient with a thin mandible.
10.17245/jdapm.2016.16.4.317
- Author:
Hong Seok CHOI
1
;
Jong Shik OH
;
Eun Jung KIM
;
Ji Young YOON
;
Ji Uk YOON
;
Cheul Hong KIM
Author Information
1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea.
- Publication Type:Case Report
- Keywords:
Airway management;
Edentulous jaw;
Mandibular reconstruction
- MeSH:
Airway Management*;
Airway Obstruction;
Bronchoscopes;
Female;
Humans;
Intubation;
Jaw, Edentulous;
Lip;
Mandible*;
Mandibular Reconstruction;
Masks;
Middle Aged;
Mouth Mucosa;
Osteomyelitis;
Tongue;
Ventilation
- From:Journal of Dental Anesthesia and Pain Medicine
2016;16(4):317-320
- CountryRepublic of Korea
- Language:English
-
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.
