Difficult airway management in a patient with a thin mandible
최홍석, 오종식, 김은정, 윤지영, 윤지욱, 김철홍,
소속 상세정보
최홍석 ( Choi Hong-Seok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
오종식 ( Oh Jong-Shik ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김은정 ( Kim Eun-Jung ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
윤지영 ( Yoon Ji-Young ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
윤지욱 ( Yoon Ji-Uk ) - Pusan National University School of Medicine Department of Anesthesiology and Pain Medicine
김철홍 ( Kim Cheul-Hong ) - Pusan National University Dental Hospital Department of Dental Anesthesia and Pain Medicine
KMID : 0980320160160040317
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.
키워드
Airway management; Edentulous jaw; Mandibular reconstruction
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