| CLINICAL INVESTIGATION |
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| Year : 2008 | Volume
: 52
| Issue : 3 | Page : 311-316 |
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Airway Management in Maxillofacial Trauma: A Retrospective Review of 127 Cases
V Saraswat
Prof. and Head, Senior Advisor, Anaesthesiology, Command Hospital (Air Force), Bangalore - 560007, India
Correspondence Address:
V Saraswat
Command Hospital Air Force, Airport Road, Agram Post, Bangalore - 560007
India
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Maxillofacial injuries are the result of high velocity trauma arising from road traffic accidents, gunshots and missile injuries. These injuries require emergency airway management in prehospital and hospital settings and as well as for reconstruction of fractures subsequently. Anaesthesiologist must be conversant with the alternative techniques and appliances.
One hundred twenty seven cases of maxillofacial injuries, treated over a period of three years in a service hospital were reviewed. Fracture mandible was most common injury (51%) followed by fractures of maxilla and zygoma (35%). Nasal intubation with direct visualization of vocal cords was most common (56%) and this was followed by oral intubation (17%). Blind awake nasal intubation was carried out in 20%. Fibreoptic bronchoscope and preoperative tracheostomy were other methods of airway management.
Maxillofacial injuries need special attention since it involves difficult airway due to fracture to facial bones, Further the airway is shared with surgeon and restrictions are imposed during surgery. Issues involved are time of surgery, preoperative airway assessment, type of intubation and way to achieve it, alternative methods available and their complications. |
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