Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery
Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrog...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-01-01
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| Series: | Journal of Oral Biology and Craniofacial Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212426817301549 |
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| author | Ashwant Kumar Vadepally Ramen Sinha A.V.S.S. Subramanya Kumar |
| author_facet | Ashwant Kumar Vadepally Ramen Sinha A.V.S.S. Subramanya Kumar |
| author_sort | Ashwant Kumar Vadepally |
| collection | DOAJ |
| description | Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening. Indications for this technique were mandibular fracture (n = 6), oral submucous fibrosis (OSMF; n = 6), temporomandibular joint (TMJ) ankylosis (n = 4) and internal derangement of TMJ (n = 2). All patients were assessed for preoperative interincisal opening; during intubation through specific parameters and; also postoperative findings were observed. Results: Mean time taken for successful intubation was 5.6 min ± 1.66. One patient had subcutaneous emphysema which was managed conservatively. Postoperatively, four patients had sore throat which resolved in few days. No other complications were encountered. Conclusion: In conclusion, retrograde nasotracheal intubation is an effective and useful technique for airway control in patients with LMO and with only a small risk potential. |
| format | Article |
| id | doaj-art-3507d121a0c64b05abff51b8df8b5b9c |
| institution | Kabale University |
| issn | 2212-4268 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Oral Biology and Craniofacial Research |
| spelling | doaj-art-3507d121a0c64b05abff51b8df8b5b9c2024-11-23T06:27:25ZengElsevierJournal of Oral Biology and Craniofacial Research2212-42682018-01-01813034Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgeryAshwant Kumar Vadepally0Ramen Sinha1A.V.S.S. Subramanya Kumar2Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India; Corresponding author at: Plot no: 31, Street no: 8, Habsiguda, Hyderabad, Telangana, India.Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, IndiaDepartment of anesthesia, Sri Sai College of Dental Surgery, Vikarabad, Telangana, IndiaBackground: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening. Indications for this technique were mandibular fracture (n = 6), oral submucous fibrosis (OSMF; n = 6), temporomandibular joint (TMJ) ankylosis (n = 4) and internal derangement of TMJ (n = 2). All patients were assessed for preoperative interincisal opening; during intubation through specific parameters and; also postoperative findings were observed. Results: Mean time taken for successful intubation was 5.6 min ± 1.66. One patient had subcutaneous emphysema which was managed conservatively. Postoperatively, four patients had sore throat which resolved in few days. No other complications were encountered. Conclusion: In conclusion, retrograde nasotracheal intubation is an effective and useful technique for airway control in patients with LMO and with only a small risk potential.http://www.sciencedirect.com/science/article/pii/S2212426817301549IntubationLimited mouth openingMaxillofacial surgeryNasotrachealRetrograde Intubation |
| spellingShingle | Ashwant Kumar Vadepally Ramen Sinha A.V.S.S. Subramanya Kumar Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery Journal of Oral Biology and Craniofacial Research Intubation Limited mouth opening Maxillofacial surgery Nasotracheal Retrograde Intubation |
| title | Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery |
| title_full | Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery |
| title_fullStr | Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery |
| title_full_unstemmed | Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery |
| title_short | Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery |
| title_sort | retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery |
| topic | Intubation Limited mouth opening Maxillofacial surgery Nasotracheal Retrograde Intubation |
| url | http://www.sciencedirect.com/science/article/pii/S2212426817301549 |
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