Quest for an Ideal Route of Intubation for Oral and Maxillofacial Surgical Manoeuvres

Vadepally, Ashwant Kumar; Sinha, Brig Ramen; Subramanya, Anshul; Agarwal, Anmol

doi:10.1007/s12663-015-0812-3

Cited by 10 publications

(13 citation statements)

References 29 publications

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“…One report of 634 elective maxillofacial surgeries found that 579 patients were intubated nasally. 17 Given that many authors advocate for fiberoptic nasal intubation over conventional nasotracheal intubation, 18 there appears to be ample need for FOI in oral and maxillofacial surgery. Although our hood is especially beneficial for awake FOI because of expected coughing and aerosol generation, this protocol is equally effective for both awake and sleep patients by either oral or nasal route of FOI.…”

Section: Discussionmentioning

confidence: 99%

A Novel Approach to Fiberoptic Intubation in Patients With Coronavirus Disease 2019

Emery

Saniukovich

Lang

et al. 2020

Journal of Oral and Maxillofacial Surgery

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In an effort to protect health care workers at the beginning and end of oral and maxillofacial surgeries, we describe a negative-pressure intubation hood (NPIH) designed to reduce the risk aerosol exposure from fiberoptic intubation (FOI) and extubation. This design is especially important during the Coronavirus disease 2019 era, as it provides greater protection from Severe Acute Respiratory Syndrome-Coronavirus-2 during FOI and extubation, which are some of the most high-risk, aerosol generating procedures of oral and maxillofacial surgery cases. Materials and Methods: This article describes the step-by-step process of assembling a NPIH for FOI using various supplies found commonly in hospitals and surrounding community retail stores, which include transparent medical dressings, equipment covers, intravenous pole clips, polyvinylchloride pipes and adaptors, copper pipe, and a Buffalo smoke evacuator. We then discuss how to create access ports for the anesthesiologist to insert their arms and FOI instrumentation and provide a demonstration of us using the hood with a manikin on an operating room table. Results: This study successfully demonstrates a novel technique for performing FOI in a NIPH assembled from basic supplies found commonly among hospital and community retail stores. Conclusions: This NIPH for FOI is easily made and adaptable to operating room tables, and provides protection against aerosols generated from FOI and subsequent extubation during oral and maxillofacial surgeries.

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Section: Discussionmentioning

confidence: 99%

A Novel Approach to Fiberoptic Intubation in Patients With Coronavirus Disease 2019

Emery

Saniukovich

Lang

et al. 2020

Journal of Oral and Maxillofacial Surgery

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“…All patients were operated under general anesthesia with fiberoptic nasotracheal intubation. 8 Initially fibrous bands were incised deep to connective tissue extending posteriorly from the pterygomandibular raphe and/or anterior faucial pillars including buccinator muscle to as far as corner of the mouth anteriorly depending on the extent of palpable fibrous bands. The fibrous bands were disentangled with finger dissection and manipulation until no restriction was felt.…”

Section: Methodsmentioning

confidence: 99%

A comparative clinical study on physiotherapy outcomes with wooden tongue depressors versus Heister jaw opener in oral submucous fibrosis patients

Vadepally

Salavadi

Sinha

2019

Journal of Oral Biology and Craniofacial Research

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The aim of this study was to compare mouth opening exercise outcomes with wooden tongue depressors (WTDs) versus Heister jaw opener (HJO) in improving mouth opening after reconstruction of the surgical defect with buccal fat pad (BFP) in oral submucous fibrosis (OSF) patients. Materials and methods: Fifty consecutive patients were divided randomly into two groups (25 patients in each group) corresponding to postoperative physiotherapy with WTDs (group 1) and HJO (group 2) respectively. Groups 1 and 2 were evaluated for maximum interincisal distance at 3, 6 and 12 months of follow up. In groups 1 and 2, mouth opening differed substantially at all periods of follow up from preoperative values. Results: The increase in mouth opening was greater in group 2 at 3 (P = 0.003) and 6 (P = 0.010) month follow up visit respectively. No relevant difference was observed in mouth opening between groups 1 and 2 at 12 months (P = 0.066). The mean increase in mouth opening at 12 months compared with the preoperative value was 22.2 mm in group 1 and 25 mm in group 2. Conclusion: We conclude both WTDs and HJO are effective in improving postoperative mouth opening in OSF surgical patients.

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“…[ 1 ] In the repair of cleft lip and palate, nasotracheal intubation would hinder with closure of muscle and mucosa. [ 2 ] Hence, oral intubation becomes more favorable in such clinical situations. In complex craniomaxillofacial trauma, the airway is secured through a tracheostomy.…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 6 7 ] Previous studies have undertaken endeavors to gather, examine, and denote a wide variety of aspects, to evaluate the optimal route of intubation that may be planned for different oral and maxillofacial surgical maneuvers. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

Awareness among anesthesia residents pertaining to various intubation techniques in craniofacial surgery: A questionnaire study

Tuli

Orvakonde

et al. 2021

Natl J Maxillofac Surg

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Aim: This study was intended to evaluate the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. Materials and Methods: A cross-sectional survey research design was employed in this study. A self-administered questionnaire survey was used to validate the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. In this regard, a preliminary study with a convenience sample of 156 anesthesia residents studying in various medical institutions across South India was conducted so as to assess the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. This study, while limited in sample size, benefits the craniofacial surgeons and anesthetists as target readers to assess the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery Results: The results of this study reveal that majority of the anesthesia residents encountered craniofacial surgery during their residency period. However, only 19.87% have performed various intubation techniques that are employed in craniofacial surgery. Nearly 38.46% of the participants felt that blind awake intubation is the most difficult intubation technique to employ in the head-and-neck region and requires expertise. Nearly 78.84% of the participants felt that special training is required for handling craniofacial surgical cases under general anesthesia. Conclusion: The results of this study reveal that there is a dearth of knowledge and clinical exposure among anesthesia residents regarding various intubation techniques employed in craniofacial surgery. Educational and quality improvement initiatives in various intubation techniques could enhance anesthesia residents' knowledge and clinical exposure in managing various craniofacial surgical cases.

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Quest for an Ideal Route of Intubation for Oral and Maxillofacial Surgical Manoeuvres

Cited by 10 publications

References 29 publications

A Novel Approach to Fiberoptic Intubation in Patients With Coronavirus Disease 2019

A Novel Approach to Fiberoptic Intubation in Patients With Coronavirus Disease 2019

A comparative clinical study on physiotherapy outcomes with wooden tongue depressors versus Heister jaw opener in oral submucous fibrosis patients

Awareness among anesthesia residents pertaining to various intubation techniques in craniofacial surgery: A questionnaire study

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