Vol 5 No 10 (2019): EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063)
Articles

Predicted difficult airways management in maxillofacial surgery. CHU – JDR Antananarivo Madagascar

Sidonie RAKOTONOMENJANAHARY
Service d’Anesthésie et de Réanimation du Centre Hospitalier Universitaire Joseph Dieudonnée Rakotovao (CHUJDR) Antananarivo Madagascar
Tanjonirina RAZAFINDRAINIBE
Service de Réanimation du Centre Hospitalier Universitaire Gynéco – Obstetrique Befelatanana (CHUGOB) Antananarivo Madagascar
Nadia Marie Philibertine RAHANITRINIAINA
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
Tantely Anjarahaingo Voahangiarivola RANDRIAMANDRATO
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
Tovohery Andriambelo RAJAONERA
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
John Alberto Bam RAZAFINDRABE
Service de Chirurgie Maxillo – faciale du Centre Hospitalier Universitaire Joseph Dieudonnée Rakotovao (CHUJDR) Antananarivo Madagascar
Published October 19, 2019
Keywords
  • algorithm,
  • difficult airways management,
  • maxillofacial surgery
How to Cite
Sidonie RAKOTONOMENJANAHARY, Tanjonirina RAZAFINDRAINIBE, Nadia Marie Philibertine RAHANITRINIAINA, Tantely Anjarahaingo Voahangiarivola RANDRIAMANDRATO, Tovohery Andriambelo RAJAONERA, & John Alberto Bam RAZAFINDRABE. (2019). Predicted difficult airways management in maxillofacial surgery. CHU – JDR Antananarivo Madagascar. EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063), 5(10), 01-13. Retrieved from https://ephjournal.com/index.php/mhs/article/view/1568

Abstract

Aim of the work: To describe the practice of predicted difficult airways management in maxillofacial surgery and to propose a draft management algorithm.

Methods: This is a two-year retrospective, descriptive study, including all patients with one or more predictive criteria for difficult intubation.

Results: We selected 63 patients with 08% of difficult intubation and 02% of which are impossible intubation. A male predominance was noted (sex ratio = 1.3) with a mean age of 38.93 years and an average weight of 59.6 kg. The intervention is dominated by tumor resection (49%). The Mallampati could not be evaluated in 41% of cases, and the mouth opening less than 6 cm is 57% of the evaluated cases. The grades of Cormack III and IV are 40%.

               Nasotracheal intubation was performed in 47 patients; orotracheal intubation in 25 patients and tracheotomy in 08 patients; and there was a case of awakened patient. The success rate of the Eschmann’s gum elastic bougie was 86% and the fibroscopy 67%.

Conclusion: The contiguity of the airways and the anatomical damage of the lesion require specific management of a difficulty in access to the airway during anesthesia of maxillo- facial surgery. The decision of the materials and techniques used is dictated by the mouth opening, the condition of the intraoral airways and the surgical approach.

 

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