scholarly journals A fiberoptic orotracheal intubation successfully performed using a modified Guedel airway in a sedated emergency patient - A case report -

2020 ◽  
Vol 15 (3) ◽  
pp. 378-382
Author(s):  
Jaeyoung Yang ◽  
Seonjin Kim ◽  
Bousung Lee ◽  
Kwanghaeng Lee ◽  
Dongseok Kim ◽  
...  
Keyword(s):  
Mouth Opening ◽  
Emergency Operation ◽  
Orotracheal Intubation ◽  
Fiberoptic Intubation ◽  
Male Body ◽  
Emergency Patient ◽  
Limited Mouth Opening ◽  
Airway Assessment ◽  
Safe Technique ◽  
Longitudinal Channel

BackgroundAn airway assessment is usually best performed before an elective operation. But in an emergency operation, proper airway assessment can often be difficult. Fiberoptic intubation is a powerful and safe technique to deal with airway difficulty, but it requires a lot of training to be able to perform correctly. There are various specialized oral airways for fiberoptic intubation, but none of them have perfect functionality.CaseA 75-year-old male (body weight 71.6 kg, height 159.3 cm, body mass index 28.22 kg/m2) was diagnosed with acute appendicitis, and it was decided to do a laparoscopic appendectomy. After the induction of general anesthesia, it was impossible to insert the direct laryngoscope deep enough for vocal cord visualization without damaging the teeth because of limited mouth opening. We successfully performed fiberoptic intubation with a newly modified Guedel airway via a longitudinal channel on the convex side and a distal opened lingual end.ConclusionsOur modified Guedel airway can be useful in assisting fiberoptic intubation in unexpectedly difficult airway situations.

scholarly journals Fiberoptic Intubation as a Boon in Limited Mouth Opening Surgeries

2011 ◽  
Vol 2 (4) ◽  
pp. 350-352
Author(s):  
Sunil Dutt ◽  
Salman Basha
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Difficult Intubation ◽  
Mouth Opening ◽  
Orotracheal Intubation ◽  
Fiberoptic Intubation ◽  
Present Case Report ◽  
Limited Mouth Opening ◽  
Temporomandibular Joint Ankylosis ◽  
Joint Ankylosis

ABSTRACT Surgery of temporomandibular joint ankylosis under general anesthesia poses a great challenge to anesthesiologists. This surgery falls in the category of difficult intubation as direct vocal cord visualization is difficult due to an inability to open the mouth. The present case report suggests that the fiberoptic intubation has become an essential skill for anesthetists dealing with patients in whom orotracheal intubation is anatomically difficult.

scholarly journals Difficult Airway Management in a Patient With Nicolaides-Baraitser Syndrome Who Had a Small Jaw and Limited Mouth Opening

2020 ◽  
Vol 68 (1) ◽  
pp. 47-49
Author(s):  
Saori Taharabaru ◽  
Takehito Sato ◽  
Kimitoshi Nishiwaki
Keyword(s):  
Genetic Disorder ◽  
Mouth Opening ◽  
Video Laryngoscope ◽  
Treacher Collins Syndrome ◽  
Fiberoptic Intubation ◽  
Facial Features ◽  
Limited Mouth Opening ◽  
Oral Intubation ◽  
First Case ◽  
Difficult Airways

Nicolaides-Baraitser syndrome (NCBRS) is a rare congenital genetic disorder characterized by distinctive facial features similar to Treacher Collins syndrome (TCS). We report the first case of successful nasal fiberoptic intubation in a patient with NCBRS with micrognathia and limited mouth opening due to trismus. A 9-year-old girl with NCBRS and dental caries was scheduled to undergo general anesthesia for a dental extraction. Initial attempts at oral intubation using a video laryngoscope were unsuccessful. However, subsequent attempts at nasal intubation using a flexible fiberoptic scope were successful. This report highlights that patients with NCBRS may present with difficult airways to manage and intubate.

scholarly journals The importance of videolaryngoscopy in maxillofacial practice associated with restricted mouth opening in traumatized patients

2021 ◽  
Vol 10 (2) ◽  
pp. e12010212178
Author(s):  
Leonardo Alan Delanora ◽  
Ana Maira Pereira Baggio ◽  
Nathália Januario de Araujo ◽  
William Phillip Pereira da Silva ◽  
Leonardo Perez Faverani ◽  
...  
Keyword(s):  
Clinical Case ◽  
Mouth Opening ◽  
Orotracheal Intubation ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Success Rates ◽  
Trauma Victim ◽  
Limited Mouth Opening ◽  
Video Cameras ◽  
Team Planning

Orotracheal intubation is considered the most delicate maneuver performed by anesthesiologists, and failure to manage the airways is one of the main causes of possible complications that can be catastrophic during its performance, thus requiring good team planning. Anatomical and / or physiological characteristics, such as limited mouth opening, a condition often found in patients suffering from fractures of the zygomatic arch or who have some abnormality in the temporomandibular joint (TMJ), can characterize a difficult airway, which demands attention greatest of the professional. Therefore, in order to overcome the obstacles that may occur during a difficult or unexpected intubation, new tools have been used, such as videolaryngoscopy in which an intubation device containing miniature video cameras is used in order to allow the operator has an indirect view of the glottis to increase success rates and decrease intubation time. The aim of the present study is to report a clinical case of a trauma victim, with limited mouth opening, who underwent intubation with the aid of a video laryngoscope after failed attempts at conventional intubation.

scholarly journals Acute Awake Fiberoptic Intubation in the ICU in a Patient with Limited Mouth Opening and Hypoxemic Acute Respiratory Failure

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Kjartan E. Hannig ◽  
Rasmus W. Hauritz ◽  
Christian Jessen ◽  
Anders M. Grejs
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Mouth Opening ◽  
Fiberoptic Intubation ◽  
Limited Mouth Opening ◽  
Emergency Airway ◽  
Hypoxemic Acute Respiratory Failure ◽  
Feasible Option ◽  
Difficult Airways ◽  
Awake Fiberoptic Intubation

The incidence and survival of patients with head-and-neck cancer have been on the increase for decades. Following surgery or radiation therapy, complications such as difficult airways may evolve. These difficult airways may be unique and not manageable with conventional intubation methods as well as video laryngoscopes. Acute awake fiberoptic intubation may be a feasible option also for urgent emergency airway management of known difficult airways. The “cannot intubate–cannot oxygenate” (CI–CO) situation has to be avoided at all costs, since emergency cricothyrotomy has a fail ratio of more than 50% when performed by an anesthesiologist.

scholarly journals Awake fi beroptic intubation of a patient with amyotrophic lateral sclerosis: case report

2012 ◽  
Vol 2 (3) ◽  
pp. 236-237
Author(s):  
Elif Bakı ◽  
Elif Buyukerkmen ◽  
Yüksel Ela ◽  
Serdar Kokulu ◽  
Remziye Sıvacı
Keyword(s):  
Intensive Care Unit ◽  
Amyotrophic Lateral Sclerosis ◽  
Intensive Care ◽  
Motor Neurons ◽  
Amyotrophic Lateral Sclerosis Patient ◽  
Mouth Opening ◽  
Fiberoptic Intubation ◽  
Limited Mouth Opening ◽  
Volume Controlled Ventilation ◽  
Lateral Sclerosis

Amyotrophic Lateral Sclerosis is a rapidly progressive disease from the fi fth to sixth decades of life causing degeneration and death of the upper and lower motor neurons and no effective treatment. The diagnosis isdependent on the clinical presentation and consistent electrodiagnostic studies. Progressive denervation affects the muscles, causing muscular weakness and atrophy, when the ventilation muscles are affected deathdue to respiratory failure occurs within a few years. We present the case of a 54 years old, 180 cm height and 94 kg weight male patient with amyotrophic lateral sclerosis who underwent surgical treatment of thyroidcancer. Fiberoptic intubation was orally performed providing spontaneus breathing. Propofol was applied after passing vocal cords. Anesthesia was maintained with sevofl orane (%2) and a mixture of oxygen and airunder volume controlled ventilation. Rocuronium was used 20 mg at the beginning of the surgery. At the end of surgery, he wasn’t extubated and transferred to anesthesia intensive care unit. He was extubated after tenhours and he was awaked perfectly. The patient was discharged from intensive care unit after 24 hours and from hospital after ten days. We reported that amyotrophic lateral sclerosis patient with limited mouth opening who underwent thyroid surgery, using awake intubation.

Severe Pain and Limited Mouth Opening Due to TMJ Chondromatosis: a Case Report

2021 ◽  
Vol 3 (5) ◽  
pp. 1227-1232
Author(s):  
Lucas Maia Nogueira ◽  
Isabela Wolf Grotto ◽  
Samuel de Souza Moraes ◽  
Fabio Ricardo Loureiro Sato ◽  
Érica Cristina Marchiori
Keyword(s):  
Case Report ◽  
Severe Pain ◽  
Mouth Opening ◽  
Limited Mouth Opening

scholarly journals Fabrication of Customized Sectional Impression Trays in Management of Patients with Limited Mouth Opening: A Simple and Unique Approach

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Vamsi Krishna CH ◽  
K. Mahendranadh Reddy ◽  
Nidhi Gupta ◽  
Y. Mahadev Shastry ◽  
N. Chandra Sekhar ◽  
...  
Keyword(s):  
Case Reports ◽  
Mouth Opening ◽  
Limited Mouth Opening ◽  
Significant Step ◽  
Removable Prosthesis ◽  
Unique Approach ◽  
Submucous Fibrosis ◽  
The Common ◽  
Proper Orientation

Impression making is not only important but is also the most significant step in the fabrication of any fixed or removable prosthesis. Proper impression making may be hindered by certain pathologic conditions. Reduced mouth opening is one of the common mechanical obstructions for proper orientation of the impression tray in the patient’s mouth. In patients with trismus induced by submucous fibrosis, the procedure may be even more difficult to carry out because of reduced tissue resiliency and obliteration of vestibular spaces. Use of sectional trays offers one of the alternatives to overcome the problem of restricted mouth opening. Fabrication of customized impression trays according to the patient dentition improves the accuracy of impression making. The present case reports describe the fabrication of sectional custom trays designed for dentulous patients with chronic tobacco-induced submucous fibrosis.

scholarly journals Anaesthesia management of a difficult airway patient with severe aortic stenosis for major oncosurgery

2021 ◽  
Vol 8 (4) ◽  
pp. 597-599
Author(s):  
Ninad Chodankar ◽  
Disha Kapadia ◽  
Hemant Mehta
Keyword(s):  
Aortic Stenosis ◽  
Difficult Airway ◽  
Severe Aortic Stenosis ◽  
Mouth Opening ◽  
Perioperative Period ◽  
Fiberoptic Intubation ◽  
Team Approach ◽  
Free Fibula Flap ◽  
Early Recovery ◽  
Perioperative Morbidity

Over the past few decades, oncosurgical procedures are increasing in number, require considerable expertise and training for anaesthetising such patients. Aortic Stenosis itself poses great challenge, causes significant increase in morbidity and mortality in the perioperative period. Head, neck oncosurgical procedures with difficult airway requiring awake fiberoptic intubation in such patients adds to the challenge.We describe once such case of previously operated Carcinoma of oral cavity with new growth involving mandible for excision of tumour with neck dissection and mandibular reconstruction with a free Fibula flap. This patient now presented with anticipated difficult airway with restricted mouth opening and a recent diagnosis of severe Aortic stenosis with mean gradient across aortic valve of 52mmHg and valve area 0.8 cm2.Such patient requires multidisciplinary team approach by cardiologist, anaesthesiologist, surgeon and intensivist to prevent perioperative morbidity and facilitate early recovery.

scholarly journals Prosthodontic Management of a Completely Edentulous Patient with Microstomia and Flat Ridge Mandible: A Case Report

2019 ◽  
Vol 53 (6) ◽  
Author(s):  
Michael Josef Kridanto Kamadjaja ◽  
Fatty Nada Pertiwi
Keyword(s):  
Case Report ◽  
Mouth Opening ◽  
Complete Denture ◽  
Edentulous Patient ◽  
Limited Mouth Opening ◽  
Proper Diagnosis

It is difficult to make impression and fabricate conventional dentures for patients with microstomia and flat ridge. This is a case report of 53-year-old female with limited mouth opening (25 mm) who had been wearing denture for 7 years and which was recently broken. Close mouth with suction impression method was used. Proper diagnosis and appropriate set of procedures and methods were needed for this patient. The conventional complete denture fitted with closed mouth method for this condition resulted in retentive and stable denture which was inserted and removed easily.

scholarly journals Limitation of mouth opening after radiotherapy for head and neck

2016 ◽  
Vol 64 (1) ◽  
pp. 24-29
Author(s):  
Rafael da Silva CAETANO ◽  
Paula Gabrielle de CASTRO ◽  
Paulo Henrique de Souza CASTRO ◽  
Alexandre Meireles BORBA ◽  
Álvaro Henrique BORGES ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Head And Neck ◽  
Mouth Opening ◽  
Vocal Folds ◽  
Tumor Location ◽  
The Other ◽  
Previous Surgery ◽  
Limited Mouth Opening ◽  
The Mean ◽  
Level Of Significance

ABSTRACT Objective: To evaluate the ability to open the mouth in patients undergoing radiotherapy for head and neck and the variables related to this limitation. Methods: 32 patients were evaluated six months after completion of radiotherapy sessions to treat cancer in the head and neck. The maximum mouth opening was measured using digital calipers and its association with gender, age, smoking, alcohol consumption, tumor location, chemotherapy and surgery were analyzed using the Mann-Whitney and Kruskal-Wallis tests at a level of significance of 95%. Results: The mean age of patients was 60.44 years; 87.5% were male; 81.2% were smokers; 65.6% regularly consumed alcohol. The average mouth opening was 43.17 mm and seven (21.9%) patients had trismus. The most common locations of the tumors were the tongue (31.3%) followed by the larynx and vocal folds with five (15.6%) each. No association was found between limited mouth opening and the other variables. Conclusion: In this sample, 21.9% of patients had trismus six months after completing radiotherapy. The variables gender, age, smoking habits and alcohol consumption, tumor location, previous surgery and adjunctive chemotherapy were not associated with limited mouth opening.

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