Difficult Airway Intubation Due to Mouth Opening Limitation Caused by Mandibular Abscess: A Case Report

Wiliam Yuhono, Michael Jaya
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引用次数: 0

Abstract

Appropriate management of difficult airway is imperative, particularly in cases with anticipated difficult airway. It customarily requires deliberate perioperative assessment. In this article we present a case of limited mouth opening along with restricted mobility of the temporomandibular joint secondary to mandibular abscess which requires surgical intervention. Preoperatively, difficult airway intubation was expected (based on LEMON mnemonic on preoperative evaluation). Therefore, Macintosh video laryngoscope and fiberoptic bronchoscope was prepared to aid in intubation. Due to the patient’s anxiety towards the procedure, the intubation was done while the patient is asleep. Preoxygenation was uneventfully. Following induction with general anesthesia, several attempts to conduct nasotracheal intubation using Macintosh video laryngoscope were made but all were abortive. This failed attempt is primarily due to the limited mouth opening and jaw mobility. Hence, fiberoptic bronchoscope-assisted nasotracheal intubation was conducted and was able to achieve airway patency. In conclusion, preoperative management holds great importance in selecting airway management strategy. To add, fiberoptic bronchoscope-assisted intubation is a safe option for intubation
下颌骨脓肿所致开口受限致气管插管困难1例
气道困难的适当管理是必要的,特别是在预期气道困难的情况下。通常需要慎重的围手术期评估。在这篇文章中,我们提出了一个病例的限制开口和限制活动的颞下颌关节继发于下颌骨脓肿,需要手术干预。术前预计插管困难(基于术前评估的LEMON助记器)。因此,准备了Macintosh视频喉镜和纤维支气管镜来辅助插管。由于病人对手术的焦虑,插管是在病人睡着的时候进行的。预充氧进展顺利。全麻诱导后,多次尝试使用Macintosh视频喉镜进行鼻气管插管,但均失败。这个失败的尝试主要是由于有限的张嘴和下颌活动。因此,纤维支气管镜辅助下的鼻气管插管得以实现气道通畅。综上所述,术前管理对气道管理策略的选择至关重要。此外,纤维支气管镜辅助插管是一种安全的插管选择
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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6 weeks
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