Difficult airway management in a patient with a thin mandible

Choi, Hong-Seok; Oh, Jong-Shik; Kim, Eun-Jung; Yoon, Ji-Young; Yoon, Ji-Uk; Kim, Cheul-Hong

Difficult airway management in a patient with a thin mandible

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Type: Academic journal

Author: Choi, Hong-Seok (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) Oh, Jong-Shik (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) Kim, Eun-Jung (Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute)

Journal: Korean Dental Society Of Anesthesiology Journal of dental anesthesia and pain medicine Journal of dental anesthesia and pain medicine 제16권 제4호 KCI Accredited Journals

Published: 2016.1

Pages: 317 - 320 (4page)

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Difficult airway management in a patient with a thin mandible

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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.

#Airway management #Edentulous jaw #Mandibular reconstruction

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References (13)

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Devlin H / 1991 / Alveolar ridge resorption and mandibular atrophy. A review of the role of local and systemic factors / Br Dent J 170:101~104

Klemetti E / 1993 / Effect of bone mineral density in skeleton and mandible on extraction of teeth and clinical alveolar height / J Prosthet Dent 70:21~25

Sunanda G / 2005 / Airway Assessment: Predictors of Difficult Airway / Indian J Anaesth 49:257~262

Kollias I / 1992 / Adult craniocervical and pharyngeal changes- a longitudinal cephalometric study between 22 and 42 years of age. Part I: morphological craniocervical and hyoid bone changes / Eur J Orthod 21:333~344

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Choi, Hong-Seok

Affiliation Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University