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

Clinical and epidemiological profile of patients with difficult intubation in maxillofacial surgery and stomatology.

S. RAKOTONOMENJANAHARY
Service d’Anesthésie et de Réanimation du Centre Hospitalier Universitaire Joseph Dieudonnée Rakotovao (CHUJDR) Antananarivo Madagascar
NMP. RAHANITRINIAINA
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
T. RAZAFINDRAINIBE
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
TAV. RANDRIAMANDRATO
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
AT. RAJAONERA
Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
Published October 19, 2019
Keywords
  • chirurgie maxillo,
  • faciale,
  • critère prédictif,
  • intubation difficile
How to Cite
S. RAKOTONOMENJANAHARY, NMP. RAHANITRINIAINA, T. RAZAFINDRAINIBE, TAV. RANDRIAMANDRATO, & AT. RAJAONERA. (2019). Clinical and epidemiological profile of patients with difficult intubation in maxillofacial surgery and stomatology. EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063), 5(10), 38-47. Retrieved from https://ephjournal.com/index.php/mhs/article/view/1571

Abstract

Aim of the work: To describe clinical and epidemiological profile of patients with difficult intubation in maxillofacial surgery and stomatology.

Methods: This is a descriptive retrospective study over a period of two years (April 2017 to May 2019) at the University Hospital Joseph Dieudonné Rakotovao (CHU - JDR) Antananarivo. This includes all patients whose intubation lasted more than 10 minutes and / or more than three attempts, or could not be performed.

Results: Twenty-eight (28) patients were collected with difficult intubation rate of 8%. A male predominance was found (sex ratio = 2.25) and the lesions are mainly of tumoral origin (54%), sitting at the level of the mandible (43%) and locating on the right side (54%). The classification of Mallampati and measurement of mouth opening could not be evaluated in 39% and 18% of cases respectively. For the classic criteria that were able to evaluate: the classification of mallampati III and IV = 59%, the mouth opening less than 3.5 cm = 26% and the mento - thyroid distance less than 6cm = 4%.

Conclusion: Although the classical predictive criteria for difficult intubation are reliable, they cannot always be correctly assessed in maxillofacial surgery. And particular features of the lesion have been found in patients who presented with difficult intubation. Hence the interest of carrying out an analytical study in order to elaborate a predictive score based on the classic criteria and the characteristics of the lesion.                         

 

Downloads

Download data is not yet available.

References

  1. Bourgain J-L. Intubation difficile en chirurgie cervicofaciale. Prat En Anesth Réanimation. sept 2009;13(4):291 5.
  2. Tuzuner-Oncul AM., Kucukyavuz Z. Prevalence and prediction of difficult intubation in maxillofacial surgery patients. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. août 2008; 66(8):1652 8.
  3. Boisson-Bertrand, Bourgain JL, Camboulives J, Crinquette V, Cros AM, Dubreuil M, et al. Intubation difficile: Société française d’anesthésie et de réanimation Expertise collective. Ann Fr Anesth Réanimation. 1 janv 1996;15(2):207 14.
  4. Cros A-M. Réactualisation de la conférence d’experts sur l’intubation difficile : et après ? Ann Fr Anesth Réanimation. janv 2008;27(1):1 2.
  5. Roth D, Pace NL, Lee A, Hovhannisyan K, Warenits AM, Arrich J, et al. Bedside tests for predicting difficult airways: an abridged Cochrane diagnostic test accuracy systematic review. Anaesthesia [Internet]. 6 mars 2019 ; Disponible sur: http://doi.wiley.com/10.1111/anae.14608
  6. Soydan SS, Bayram B, Akdeniz BS, Kayhan Z, Uckan S. Changes in difficult airway predictors following mandibular setback surgery. Int J Oral Maxillofac Surg. nov 2015;44(11):1351 4.
  7. Mohamedbhaia H, Ali S, Dimasia I, Kalavrezosa N. TRACHY score: a simple and effective guide to management of the airway in head and neck cancer. Br J Oral Maxillofac Surg. 1 oct 2018;56(8):709 14.
  8. Wahal R. Temporo-mandibular joint ankylosis – The difficult airway. J Oral Biol Craniofacial Res. mai 2015;5(2):57 8.
  9. Maes J-M, Raoul G, Omezzine M, Ferri J. Ostéites des os de la face. EMC - Stomatol. sept 2005;1(3):208‑30.