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Fibreoptic aided retrograde intubation in an oral cancer patient.

Das S, Mandal MC, Gharami BB, Bose P - Indian J Anaesth (2011)

View Article: PubMed Central - PubMed

Affiliation: North Bengal Medical College, West Bengal, India.

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Recently we encountered such a patient and we combined both retrograde and fibreoptic (FOB) intubation in a difficult airway situation, compromised by a large oral cavity mass... We had three options: blind nasal, FOB and tracheostomy... Blind nasal is a simple technique, but success at first pass is less and there is more trauma and bleeding with more attempts... This may result in failure to visualise during subsequent FOB attempts... In retrograde intubation, the endotracheal tube may move out of the larynx into the oesophagus or kink with failure to advance after guide catheters are removed... Herein lies the importance of this modified technique that utilises a guidewire introduced with the retrograde approach which is subsequently used to guide the FOB for speedy advancement into the oropharynx occupied with tumour... We used a sterile Terumo guidewire intended primarily to cannulate the common bile duct... The tip of this guidewire is very soft and becomes slimy in the presence of water so that it finds its way even in a small opening... So, chance of retrieving the catheter from the mouth or nostril at first pass, in the presence of an airway tumour, is more... Though not impossible, tracheostomy under local anaesthesia is difficult in advanced oropharyngeal cancers causing anatomical distortion of the anterior neck... This combination technique may be helpful to secure the airway reliably, safely and quickly in oral cancer patients requiring awake tracheal intubation for anticipated difficult airway situations.

No MeSH data available.


Intubated awake patient with a secure airway (permission for publication obtained from the patient)
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Figure 0003: Intubated awake patient with a secure airway (permission for publication obtained from the patient)

Mentions: The position of the tracheal tube was checked. Oxygen insufflation through the scope was done during the procedure. The patient tolerated the procedure well [Figure 3].


Fibreoptic aided retrograde intubation in an oral cancer patient.

Das S, Mandal MC, Gharami BB, Bose P - Indian J Anaesth (2011)

Intubated awake patient with a secure airway (permission for publication obtained from the patient)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3106402&req=5

Figure 0003: Intubated awake patient with a secure airway (permission for publication obtained from the patient)
Mentions: The position of the tracheal tube was checked. Oxygen insufflation through the scope was done during the procedure. The patient tolerated the procedure well [Figure 3].

View Article: PubMed Central - PubMed

Affiliation: North Bengal Medical College, West Bengal, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Recently we encountered such a patient and we combined both retrograde and fibreoptic (FOB) intubation in a difficult airway situation, compromised by a large oral cavity mass... We had three options: blind nasal, FOB and tracheostomy... Blind nasal is a simple technique, but success at first pass is less and there is more trauma and bleeding with more attempts... This may result in failure to visualise during subsequent FOB attempts... In retrograde intubation, the endotracheal tube may move out of the larynx into the oesophagus or kink with failure to advance after guide catheters are removed... Herein lies the importance of this modified technique that utilises a guidewire introduced with the retrograde approach which is subsequently used to guide the FOB for speedy advancement into the oropharynx occupied with tumour... We used a sterile Terumo guidewire intended primarily to cannulate the common bile duct... The tip of this guidewire is very soft and becomes slimy in the presence of water so that it finds its way even in a small opening... So, chance of retrieving the catheter from the mouth or nostril at first pass, in the presence of an airway tumour, is more... Though not impossible, tracheostomy under local anaesthesia is difficult in advanced oropharyngeal cancers causing anatomical distortion of the anterior neck... This combination technique may be helpful to secure the airway reliably, safely and quickly in oral cancer patients requiring awake tracheal intubation for anticipated difficult airway situations.

No MeSH data available.