Naslov
AWAKE FIBEROPTIC TRACHEAL INTUBATION AND ATRISK EXTUBATION IN A PATIENT WITH ANTICIPATED DIFFICULT AIRWAY DUE TO POST-TRAUMATIC ANKYLOSIS OF TEMPOROMANDIBULAR JOINTS

Autori
Ivan Beneš, Mislav Kasalo, Andrea Peršin Beraković, Igor Blivajs, Dinko Leović, Renata Curić Radivojević

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
„The airway from the perspective of various medical professions“.Book of abstracts / Goranović, T - Zagreb : Hrvatski liječnički zbor, Hrvatsko društvo za zbrinjavanje otežanoga dišnog puta Croatian Medical Association, Croatian Society of Difficult Airway Management Predsjednica / President: Tatjana Goranović, 2022, 34-34

ISBN
978-953-7959-90-6

Skup
4th Croatian Congress of Airway Management with International Participation „The airway from the perspective of various medical professions“.

Mjesto i datum
Zagreb, Hrvatska, 16.09.2022. - 18.09.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
awake fiberoptic intubation ; at risk extubation ; difficult airway, trismus

Sažetak
In this case report we present successful airway management in a patient with predicted difficult airway using the Difficult Airway Society guidelines. Our patient presented with recurrence of reduced mouth opening due to post-traumatic bilateral temporomandibular ankylosis. Temporomandibular joint (TMJ) ankylosis often occurs after misdiagnosis, delayed treatment, inadequate surgery, prolonged immobilization or insufficient physiotherapy for intracapsular or subcondylar mandibular fractures. This condition is challenging to treat because it requires complete release of ankylosis followed by restoration of the condylar height to facilitate a full range of motion and good occlusion. As this is one of the most important predictors of difficult airway management, awake fiberoptic intubation was planned. After light sedation and thorough tropicalisation of the nasal cavity the flexible optic bronchoscope was successfully navigated into the trachea with “spray-as-yougo” technique and the endotracheal tube was railroaded over it. After a two-point check of the endotracheal tube placement the patient was put under anesthesia. The surgery was uneventful. The ankylosis of both temporomandibular joints was approached through temporal and periauricular cuts. The condylar processes were resected and the mandible was separated from the temporal bone on both sides. After the surgery, the patient was transferred to the ICU, intubated till airway edema relieves. Finally, a plan for a safe extubation was instituted and the patient was extubated uneventfully on the next day using the airway exchange catheter.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Dentalna medicina

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