Awake fiberoptic orotracheal intubation using a modified Guedel airway in a patient with craniocervical instability and an anticipated difficult airway: A case report.
10.17085/apm.2018.13.4.383
- Author:
Yongjoon CHOI
1
;
Sung Won WOO
;
Ji Heui LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Korea Cancer Center Hospital, Seoul, Korea. jiheui0255@naver.com
- Publication Type:Case Report
- Keywords:
Airway;
Bronchoscope;
Guedel airway;
Instability;
Neck
- MeSH:
Airway Management;
Bronchoscopes;
Humans;
Intubation*;
Intubation, Intratracheal;
Middle Aged;
Mouth;
Neck;
Spine
- From:Anesthesia and Pain Medicine
2018;13(4):383-387
- CountryRepublic of Korea
- Language:English
-
Abstract:
In patients with upper cervical instability, airway management may provoke subluxation of the craniocervical region and neurologic injury, and can be challenging for the anesthesiologist. Endotracheal intubation using a fiberoptic bronchoscope is frequently used in these patients to minimize spine motion, but this procedure may fail in patients with altered airway anatomy. When fiberoptic endotracheal intubation fails in these patients, optional intubation methods are limited. We describe successful awake fiberoptic orotracheal intubation using a modified Guedel airway divided in the midline for a 59-year-old man with an anticipated difficult airway, due to limited mouth opening, a nasopharyngeal tumor, and craniocervical spine instability after failure of conventional fiberoptic orotracheal intubation.
