Chiara Mossinelli, Giacomo Pietrobon, Stefano Zorzi, Marta Tagliabue, Francesco Chu, Emilia Tomarchio, Daniele Sances, Marco Venturino, Mohssen Ansarin
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引用次数: 0
Abstract
Objectives: Head and neck cancer surgery (HNCS) is burdened by a great risk of difficult airway and adverse events during anaesthesia. This study describes our experience and provides a flowchart for airway management in HNCS.
Methods: We retrospectively reviewed 910 surgically treated patients (January 2022- January 2023, European Institute of Oncology, Milan, Italy). We selected malignant tumours of the upper airway and surgery performed under general anaesthesia. We report a descriptive analysis of the sample. The data collected were representative of our daily clinical practice and have been used to draw up a proposal for airway management in HNCS.
Results: 200 consecutive patients (males 71.5%, females 28.5%), median age 67 years, were selected. The most represented sites were larynx (44.5%), oral cavity (30.5%), and oropharynx (20%). Airway management was obtained by orotracheal intubation (61%), nasotracheal intubation (15%), awake intubation under fibreoptic endoscopic control (15%), and tracheostomy under local anaesthesia (9%). In 3 cases we performed tracheostomy in an emergency setting (all patients affected by laryngeal cancer in a locally advanced stage).
Conclusions: Airway management in HNCS represents a topic of compelling interest that requires careful planning, well-defined options of strategies, and close communication between anaesthesiologists and surgeons.