• 대한두개안면성형외과학회지
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• 제18권4호
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• pp.223-229
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• 2017

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.215-217
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• 2017

Branchio-oto-renal syndrome (BOR) is a rare autosomal dominant disorder. The features include branchial cysts, hearing loss, ear malformation, preauricular pits, retrognathia, congenital heart disease, and renal abnormalities. However, anesthetic management of these patients has seldom been reported. We report a case in which general anesthesia was performed for dental treatment in a patient with BOR. Airway management, renal function, and hemodynamic changes can be of critical concern during anesthetic management. A 13-year-old girl diagnosed with BOR had severe right hearing loss, right external ear malformation, renal abnormalities, and postoperative patent ductus arteriosus (PDA). Dental extraction under general anesthesia was scheduled for a supernumerary tooth. The procedure was completed with sufficient urine volume, adequate airway management, and stable hemodynamics.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.282-293
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• 2019

본 연구는 시뮬레이션 기반 응급기도관리 교육프로그램을 개발하고, 간호학생에게 적용하여 응급기도관리 지식, 임상수행능력, 자기효능감, 비판적 사고성향에 미치는 효과를 파악하고자 시도되었으며 연구의 대상자는 서울, 경기 소재 4년제 간호대학의 4학년 학생 30명이다. 2017년 10월 14일부터 11월 3일까지 자료수집 하였으며 자료처리 및 분석방법은 SPSS 22.0을 이용하여 빈도, 백분율, paired t-test 로 분석 하였다. 간호 시뮬레이션 기반 교육 프로그램은 ADDIE 모형을 기초로 분석, 설계, 개발, 실행, 평가의 5단계로 진행하여 개발, 적용한 결과 시뮬레이션 기반 응급기도관리 교육 프로그램이 간호학생의 응급기도관리 지식(t=-9.98, p<.001), 임상수행능력(t=-23.90, p<.001), 자기효능감(t=-16.77, p<.001), 비판적 사고성향(t=-5.04, p<.001) 향상에 모두가 유의하게 나타났다. 본 연구결과를 통해 안전한 시뮬레이션 환경에서 임상현장과 유사한 상황을 미리 경험해봄으로써 간호학생들의 실무역량 강화에 도움이 되는 교육임을 확인할 수 있었다. 따라서 본 교육 프로그램은 임상실습이 제한적인 간호학생을 위해 응급간호상황 대처 및 핵심술기 향상을 위해 간호대학에서 적극적으로 활용될 수 있을 것으로 기대된다. 또한 신규간호사와 간호사의 실무역량 강화를 위한 교육으로 활용 될 수 있을 것이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.119-123
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• 2018

In cases of intellectually disabled patients, there is sometimes difficult to obtain sufficient information due to the intellectual disorder, even though the patient has significant medical problems. Herein, we report a case of decreased oxygen saturation and inadequate air exchange during general anesthesia in an intellectually disabled patient. We also describe the subsequent management, including the diagnosis of tracheomalacia (TM) using bronchoscopy, and the management of airway compromise with manual and/or controlled respiration, which led to the prevention of complications.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.153-156
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• 2015

A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

• 한국임상수의학회지
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• 제22권3호
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• pp.214-219
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• 2005

This experiment was conducted in order to identify the effect of the laryngeal mask airway and it's clinical utility on cardiovascular system, intraocular pressure and stress reaction at the time of anesthesia care. The heart rate, systolic arterial pressure, diastolic arterial pressure and intraocular pressure were significantly reduced in the experimental group to be compared with the control group. But, there were no significant differences in mean arterial pressure, central venous pressure and blood cortisol concentration between both groups. In view of the above results, it is thought that the airway management using the laryngeal mask airway will be useful to reduce the stress condition in the induction of anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권1호
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• pp.73-75
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• 2019

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.377-378
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• 2021

• Imaging Science in Dentistry
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• 제50권2호
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• pp.105-115
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• 2020

Purpose: This study investigated the position of the hyoid bone and its relationship with airway dimensions in different skeletal malocclusion classes using cone-beam computed tomography (CBCT). Materials and Methods: CBCT scans of 180 participants were categorized based on the A point-nasion-B point angle into class I, class II, and class III malocclusions. Eight linear and 2 angular hyoid parameters(H-C3, H-EB, H-PNS, H-Me, H-X, H-Y, H-[C3-Me], C3-Me, H-S-Ba, and H-N-S) were measured. A 3-dimensional airway model was designed to measure the minimum cross-sectional area, volume, and total and upper airway length. The mean crosssectional area, morphology, and location of the airway were also evaluated. Data were analyzed using analysis of variance and the Pearson correlation test, with P values <0.05 indicating statistical significance. Results: The mean airway volume differed significantly among the malocclusion classes(P<0.05). The smallest and largest volumes were noted in class II (2107.8±844.7 ㎣) and class III (2826.6±2505.3 ㎣), respectively. The means of most hyoid parameters (C3-Me, C3-H, H-Eb, H-Me, H-S-Ba, H-N-S, and H-PNS) differed significantly among the malocclusion classes. In all classes, H-Eb was correlated with the minimum cross-sectional area and airway morphology, and H-PNS was correlated with total airway length. A significant correlation was also noted between H-Y and total airway length in class II and III malocclusions and between H-Y and upper airway length in class I malocclusions. Conclusion: The position of the hyoid bone was associated with airway dimensions and should be considered during orthognathic surgery due to the risk of airway obstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.19.1-19.7
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• 2015

Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.