Browse > Article

Failed Airway Management in a Patient with Wound Hematoma After Partial Mandibulectomy and Reconstruction with Free Flap  

Kim, Seokkon (Department of Anesthesia and Pain Medicine, College of Medicine, Dankook University)
Song, Jaegyok (Department of Anesthesia and Pain Medicine, College of Medicine, Dankook University)
Kang, Bongjin (Department of Anesthesia and Pain Medicine, College of Medicine, Dankook University)
Choi, Cheolwhan (Department of Oro-maxillo-facial surgery, College of Dental Medicine, Dankook University)
Choi, Gyuwoon (Department of Anesthesia and Pain Medicine, College of Medicine, Dankook University)
Publication Information
Journal of The Korean Dental Society of Anesthesiology / v.13, no.3, 2013 , pp. 127-131 More about this Journal
We experienced failed airway management in a patient who had partial mandibulectomy and reconstruction with free-flap. 40 year-old man (height: 164 cm, body weight: 59 kg) with malignant melanoma on #38 tooth area of mandibular body was scheduled for partial mandibulectomy and reconstruction with free flap. Approximately fifteen-hours after surgery, the patient was extubated without complication. Seven hours after extubation, we experienced respiratory failure andfailed airway managementdue to airway edema and neck. We failed orotracheal intubation with direct laryngoscopy andlaryngeal mask airway, thus we tried tracheostomy but the patient was hypoxic state for more than 30 minutes. The patient had got hypoxic brain damage in whole cerebral cortex and basal ganglia. We should have the policy of airway management of the patients who have massive oro-maxillo-facial surgery and all medical personnel who treat these patients should be educated the policy and airway management methods.
Difficult airway; Hypoxemia; Nasotracheal intubation; Tracheostomy; Wound hematoma;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Hirshoren N, Varon D, Weinberger JM, Gross M: Airway obstruction and hemophilia-A: epiglottis hematoma. Laryngoscope 2010; 120: 1428-9.   DOI
2 Frohna WJ, Lowery RC, Jr., Pita F: Lingual and sublingual hematoma causing upper airway obstruction. J Emerg Med 2012; 43: 1075-6.   DOI
3 Ikeda R, Chiba T, Gorai S, Kobayashi T: Upper airway obstruction by epiglottis and arytenoids hematoma in a patient treated with warfarin sodium. Auris Nasus Larynx 2010; 37: 114-6.   DOI
4 Birkholz T, Krober S, Knorr C, Schiele A, Bumm K, Schmidt J: A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management. J Emerg Trauma Shock 2010; 3: 409-11.   DOI
5 Del Castillo-Pardo de Vera JL, Lopez-Arcas Calleja JM, Burgueno-Garcia M: Hematoma of the floor of the mouth and airway obstruction during mandibular dental implant placement: a case report. Oral and maxillofacial surgery 2008; 12: 223-6.   DOI
6 Ledesma M, Delas F, Beltran de Heredia B, Roman J, Hernandez C, Villalonga A. Severe airway obstruction in 4 cases of postoperative obstructive hematoma. Rev Esp Anestesiol Reanim 1997; 44: 39-40.