Iatrogenic neck mobility restriction due to stereotactic fixed-frame application: Implications of a ‘non-laryngoscopic’ airway management approach

Abstract

Stereotactic biopsy is a common minimal access neurosurgical procedure. It requires a stereotactic frame to be secured on the head, and thereafter, based on computerised tomography scan markings on the frame, precise biopsy is retrieved. For anaesthesiologists, the application of frame poses difficulty in accessing the upper airway with the conventional laryngoscopy-intubation methodology. The various airway-access limitations imposed by an ‘in-place’ frame can be problematic and should be addressed. This report elucidates the problems caused by the presence of stereotactic frame in the management of upper airway. The approach to upper airway can be variable on a case-to-case basis, depending on attending anaesthesiologists’ decision-making and availability of equipments/devices. Here, the, recommendations on the problematic points and the suggested way thereof are presented.