MANAGEMENT OF DIFFICULT AIRWAY IN ORAL AND MAXILLO-FACIAL SURGERY

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VV Costan, ML Ciofu, MP Comanescu, FP Sava, E Patrascanu, VL Hartie, L Cureniuc, O Boisteanu

Abstract

The aim of this study is to describe the airway management in Oral and Maxillo-Facial Surgery in cases such as: panfacial trauma, tumors, odontogenic infections involving trismus and swelling, congenital anomalies, and others. According to The American Society of Anesthesiologists (ASA), there is not a standard definition of the difficult airway in the literature. However, they recognize the difficult airway to be one in ‘‘which a conventionally trained anesthesiologist experiences difficulty with face mask ventilation of the upper airway, difficulty with tracheal intubation, or both.’’ (1)The American Society of Anesthesiology (ASA) defines difficult intubation as: „the inability to place the endotracheal tube in 10 minutes or in 3 attempts at direct laryngoscopy”; the mask ventilation as difficult: “the inability of an anesthesiologist (with appropriate level of training) to maintain the patient’s oxygen saturation above 90% using the ventilator facial mask when starting from a normal basal saturation”. Also, difficult airway can represent difficult laryngoscopy, difficult mask ventilation, difficult endotracheal tube placement, or the failure to intubate or ventilate. (7)