Determining the Appropriate Oral Surgery Anesthesia Modality, Setting, and Team

Stronczek, Michael J.

doi:10.1016/j.coms.2013.03.008

Cited by 11 publications

(7 citation statements)

References 3 publications

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“…Surgery under local anesthesia was difficult for this patient, as gaining cooperation is difficult in her age group. 4,10 While sedation could facilitate cooperation, it could also blunt the protective reflexes of the airway from foreign body. 11,12 An airway secured with ETT was preferred to protect it from secretions and blood that may accumulate during the surgery.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Tension Pneumothorax after Fiberoptic-guided Intubation in a Pediatric Patient: A Case Report

Cruz

Simon

2022

Acta Med Philipp

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Fiberoptic-guided intubation (FOI) has been an indispensable component of difficult airway management especially in instances where anatomical limitations precluded use of conventional direct laryngoscopy. Its use, however, is not without risks.This paper presents a 4-year-old female with a limited mouth opening scheduled for an elective oral commissurotomy who developed signs and symptoms of tension pneumothorax immediately following a successful fiberoptic nasotracheal intubation. Passive insufflation of high-flow oxygen through a flexible fiberoptic bronchoscope preloaded with a tight-fitting endotracheal tube led to accumulation of air. This caused lung hyperinflation and subsequently, pneumothorax.

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Section: Discussionmentioning

confidence: 99%

Iatrogenic Tension Pneumothorax after Fiberoptic-guided Intubation in a Pediatric Patient: A Case Report

Cruz

Simon

2022

Acta Med Philipp

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“…The guidelines recommended by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the American Dental Association (ADA) suggest hospital-based surgeries for patients who are scheduled for complex surgeries and who are in need of comprehensive hospital or intensive care unit (ICU) monitoring during the postoperative period 1 . However, the characteristics of patients who require complex surgery and hospital or ICU admission may vary.…”

Section: Discussionmentioning

confidence: 99%

“…Oral and maxillofacial (OMF) surgeries can be performed in office-based settings, outpatient facilities, or hospitals 1,2 . All these facilities, except office-based sites, may involve an overnight stay in a hospital 3…”

Section: Introductionmentioning

confidence: 99%

Overnight hospital stay and/or extended recovery period may allow long-duration oral and maxillofacial surgeries in the operating room of a dental hospital in an outpatient setting: a single-center experience

Üzümcügil

Yılbaş

Akça

et al. 2020

JKAOMS

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Objectives: The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting. Materials and Methods: The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed. Results: A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (P=0.389). The duration of surgery was longer in the hospitalized patient group (105.25±57.48 vs 189.62±82.03 minutes; P<0.001). Double-jaw (n=15; 310.00±54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86±61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40±41.60 vs 149.83±52.04; P<0.001). Conclusion: Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score <3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.

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“…The study sample included 28 adult patients: 17 women (60.7%) and 11 men (39.3%) aged 17-28 years (19.1 ±2.7 years). The inclusion criteria were as follows: adult normal healthy patient -according to the American Society of Anesthesiologists (ASA) classification, 19 SMC > 5 mm -according to the Ricketts analysis, 5 and age >16 years. 5 The exclusion criteria were as follows: systemic disease, syndromes, maxillofacial deformities, previous maxillofacial trauma, previous orthodontic treatment, and/or previous maxillofacial surgery.…”

Section: Patient Selectionmentioning

confidence: 99%

Volumetric upper airway changes following a new technique for Surgically-Assisted Maxillary Expansion (SAME)

2018

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Background. Skeletal maxillary constriction (SMC) is one of the common skeletal discrepancies which are associated with alterations in the respiratory function. Today, many surgical techniques are used to expand the maxilla in adult patients with no consensus about the optimal technique. Objectives. The present study aimed to investigate the changes of the upper airway volume resulting from the use of a new, minimally invasive surgically-assisted maxillary expansion (SAME) technique, and compare the results with the conventional SAME technique. Material and methods. A prospective study was conducted between September 2015 and July 2018. A total of 28 adult patients (11 males, 17 females; mean age: 19.1 ±2.7 years) with SMC underwent SAME. The sample was divided according to the applied surgical technique into 2 groups: the conventional osteotomy SAME (CO-SAME) group consisted of 13 patients (18.7 ±2.2 years) and the selective osteotomy SAME (SO-SAME) group consisted of 15 patients (19.4 ±3.2 years). Cone beam computed tomography (CBCT) scans were initially obtained preoperatively (T1) and 3 months post expansion (T2). The upper airway was divided into 2 segments: retropalatal and retroglossal. The volume of each segment and the total airway volume (TAV) were assessed using the OnDemand3D ® software. Results. The total upper airway volume showed a significant increase after both CO-SAME and SO-SAME (1.29 ±0.26 cc and 1.21 ±0.19 cc, respectively), with significant increases in retropalatal and retroglossal airway volumes (RPAV and RGAV) after both CO-SAME and SO-SAME (RPAV-0.73 ±0.10 cc and 0.83 ±0.10 cc, and RGAV-0.56 ±0.23 cc and 0.38 ±0.23 cc, respectively). No significant differences were observed in the maxillary width (MW), TAV or RGAV between the 2 SAME techniques, whereas the increase in RPAV in the SO-SAME group was significantly greater than that of the CO-SAME group. Conclusions. The new, minimally invasive SAME technique was an effective procedure to increase MW and the upper airway volume.

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Determining the Appropriate Oral Surgery Anesthesia Modality, Setting, and Team

Cited by 11 publications

References 3 publications

Iatrogenic Tension Pneumothorax after Fiberoptic-guided Intubation in a Pediatric Patient: A Case Report

Iatrogenic Tension Pneumothorax after Fiberoptic-guided Intubation in a Pediatric Patient: A Case Report

Overnight hospital stay and/or extended recovery period may allow long-duration oral and maxillofacial surgeries in the operating room of a dental hospital in an outpatient setting: a single-center experience

Volumetric upper airway changes following a new technique for Surgically-Assisted Maxillary Expansion (SAME)

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