Retrograde intubation in a case of cancrum oris with sygnathia

Abstract

Difficult intubating conditions, anticipated or unanticipated, are part of every anaesthesist's life. A large number of aids and various techniques have been described for intubating in such situations. The primary job of the anesthesiologist is to secure the airway and provide adequate ventilation to the anesthetised patient. Failure to manage difficult airway has led to many of the total deaths attributable to anesthesia. Proper airway examination and selection of appropriate method for airway intervention is of utmost importance. The retrograde intubation technique is one of the valuable alternative options in places where fiberoptic bronchoscope is not readily available or affordable in cases with anticipated difficult airway. We report a case of cancrum oris with sygnathia (fusion of jaw) leading to inability to open mouth posted for bilateral coronoidectomy with osteotomy of fused bone and lip repair. An awake retrograde nasal intubation with light sedation and local block was performed.

Noma: An Addition in the Official List of Who Neglected Tropical Diseases

“…There has been a case reported in Nepal. 13 This can also help us to assume that noma does not have very alarming situation in Nepal. However, we should also move ahead with international collaborators along with their research and strengthen our knowledge and skills.…”

Difficult Airway Management of Reconstructive Surgery for Noma (Cancrum oris): A Rare Neglected Disease

“…Preoperative evaluation plays an important role in predicting a potential difficult airway during maxillofacial manipulation in patients with Noma. 5,7 Therefore, we report a successful nasotracheal intubation using fiberoptic laryngoscope to maintain the airway during the reconstructive surgery in an adult patient with Noma.…”