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http://dx.doi.org/10.17245/jdapm.2018.18.5.309

Airway management in pediatric tongue flap division for oronasal fistula closure: A case report  

So, Eunsun (Department of Dental Anesthesiology, Seoul National University Dental Hospital)
Yun, Hye Joo (Department of Dental Anesthesiology, Seoul National University Dental Hospital)
Karm, Myong-Hwan (Department of Dental Anesthesiology, Seoul National University Dental Hospital)
Kim, Hyun Jeong (Department of Dental Anesthesiology, Seoul National University, School of Dentistry)
Seo, Kwang-Suk (Department of Dental Anesthesiology, Seoul National University, School of Dentistry)
Ha, Hyunbin (Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital)
Publication Information
Journal of Dental Anesthesia and Pain Medicine / v.18, no.5, 2018 , pp. 309-313 More about this Journal
Abstract
Oronasal fistulae (ONF) could remain after surgery in some patients with cleft palate. ONF ultimately requires intraoral surgery, which may lead to perioperative airway obstruction. Tongue flap surgery is a technique used to repair ONF. During the second surgery for performing tongue flap division, the flap transplanted from the tongue dorsum to the palate of the patient acts as an obstacle to airway management, which poses a great challenge for anesthesiologists. In particular, anesthesiologists may face difficulty in airway evaluation and patient cooperation during general anesthesia for tongue flap division surgery in pediatric patients. The authors report a case of airway management using a flexible fiberoptic bronchoscope during general anesthesia for tongue flap division surgery in a 6-year-old child.
Keywords
Airway Management; Oronasal Fistula; Tongue Flap;
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1 Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: Understanding genetic and environmental influences. Nat Rev Genet 2011; 12: 167-78.
2 Sahoo NK, Desai AP, Roy ID, Kulkarni V. Oro-nasal communication. J Craniofac Surg 2016; 27: e529-33.   DOI
3 Agrawal K. Cleft palate repair and variations. Indian J Plast Surg 2009; 42 Suppl: S102-9.   DOI
4 Guzel MZ, Altintas F. Repair of large, anterior palatal fistulas using thin tongue flaps: Long-term follow-up of 10 patients. Ann Plast Surg 2000; 45: 109-14.   DOI
5 Sadhu P. Oronasal fistula in cleft palate surgery. Indian J Plast Surg 2009; 42 Suppl: S123-8.   DOI
6 Hochberg J, Naidu R, Saunders DE. Anesthesia technique for serving the pedicle of a tongue flap in the presence of a pharyngeal flap. Plast Reconstr Surg 1978; 62: 905-6.   DOI
7 Peter S, Subash P, Paul J. Airway management during second-stage tongue flap procedure. Anesth Analg 2007; 104: 217.   DOI
8 Fung BK, Chan MY. Incidence of oral tissue trauma after the administration of general anesthesia. Acta Anaesthesiol Sin 2001; 39: 163-7.
9 Gopinath VK, Muda WA. Assessment of growth and feeding practices in children with cleft lip and palate. Southeast Asian J Trop Med Public Health 2005; 36: 254-8.
10 Rohrich RJ, Love EJ, Byrd HS, Johns DF. Optimal timing of cleft palate closure. Plast Reconstr Surg 2000; 106: 413-21.   DOI
11 Phero JC, Rosenberg MB, Giovannitti JA, Jr. Adult airway evaluation in oral surgery. Oral Maxillofac Surg Clin North Am 2013; 25: 385-99.   DOI
12 Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult airway society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth 2015; 115: 827-48.   DOI
13 Solan KJ. Nasal intubation and previous cleft palate repair. Anaesthesia 2004; 59: 923-4.   DOI
14 Sahoo TK, Ambardekar M, Patel RD, Pandya SH. Airway management in a case of tongue flap division surgery: A case report. Indian J Anaesth 2009; 53: 75-8.
15 Eipe N, Pillai AD, Choudhrie A, Choudhrie R. The tongue flap: An iatrogenic difficult airway? Anesth Analg 2006; 102: 971-3.
16 Kameyama K, Watanabe S, Kano T, Kusukawa J. Effects of nasal application of an epinephrine and lidocaine mixture on the hemodynamics and nasal mucosa in oral and maxillofacial surgery. J Oral Maxillofac Surg 2008; 66: 2226-32.   DOI
17 Andrews JI, Kumar N, van den Brom RH, Olkkola KT, Roest GJ, Wright PM. A large simple randomized trial of rocuronium versus succinylcholine in rapid-sequence induction of anaesthesia along with propofol. Acta Anaesthesiol Scand 1999; 43: 4-8.   DOI
18 Sorensen MK, Bretlau C, Gatke MR, Sorensen AM, Rasmussen LS. Rapid sequence induction and intubation with rocuronium-sugammadex compared with succinylcholine: A randomized trial. Br J Anaesth 2012; 108: 682-9.   DOI