J Korean Dent Soc Anesthesiol.  2008 Dec;8(2):118-121. 10.17245/jkdsa.2008.8.2.118.

Difficult Intubation in Patients Undergone Oromaxillary Surgery: Retrospective Study

• Kwon OS
• Kim CH

• KMID: 2345117
• DOI: http://doi.org/10.17245/jkdsa.2008.8.2.118

Abstract

BACKGROUND
This retrospective study aims to describe the airway management and to search predictive parameter for difficult intubation in 700 patients undergoing oromaxillary surgery.
METHODS
The medical records of 700 patients undergone oromaxillary surgery were reviewed for airway management during perioperative period. The cases of difficult intubation were selected and those radiologic findings were reviewed. The mandibular depth (MD), mandibular length (ML), thyromental distance (TMD) were measured.
RESULTS
In 41 cases difficult intubation were recorded in anesthetic record. The grade of Cormack and Lehane was III in 36 patients and IV in 5 cases. The MD of difficult intubation cases was 4.2 ± 3.2 cm. The ML of difficult intubation cases was 10.1 ± 3.8 cm. The TMD of difficult intubation cases was 5.9 ± 4.3 cm. Under the fiberoptic guided awake intubation was undertaken in 75 patient. In none of the cases was failed nasotracheal intubation.
CONCLUSIONS
The patients undergoing oromaxillar surgery have a potentially difficult airway but, if managed properly during perioperative preiod, morbidity and mortality can be reduced or avoided. The radiologic findings were poor predict for difficult intubation. The fiberoptic guided awake intubation is a safe alternative to direct laryngoscopic intubation.

Keyword

Airway management; Difficult intubation; Fiberoptic guided intubation; Radiologic findings

MeSH Terms

Airway Management
Humans
Intubation*
Medical Records
Mortality
Perioperative Period
Retrospective Studies*