This report describes an unusual case of an insidiously enlarged traumatic palatal perforation after orotracheal intubation in a four-year-old female child with Insulin Dependent Diabetes Mellitus (IDDM). The child was first diagnosed with diabetes at 10 months of age when she was hospitalized for pneumonia. Severe respiratory distress warranted assisted ventilation via orotracheal intubation. Multiple factors namely infection, relative immunodeficiency, poor wound healing, trauma via orotracheal intubation as well as uncontrolled glucose levels, all contributed to the formation and deterioration of the palatal perforation. A palatal obturator was fabricated as an interim treatment until surgical closure could be performed.
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http://dx.doi.org/10.7860/JCDR/2017/25751.9749 | DOI Listing |
J Neurosurg Anesthesiol
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Background: Predictors of difficult fiberscopic intubation have not been fully elucidated. This study focused on identifying radiographic predictors of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar.
Methods: This retrospective study included unconscious patients who underwent orotracheal intubation using a flexible fiberscope while wearing a cervical collar to simulate a difficult airway.
Cureus
November 2024
Intensive Medicine, Hospital Pedro Hispano, Matosinhos, PRT.
Isolated cricoid fractures are exceedingly rare but can be life-threatening. Injuries caused by minor neck trauma related to external laryngeal manipulation or an inappropriate tube cuff size have been reported in the literature. Symptoms typically appear immediately after the traumatic episode.
View Article and Find Full Text PDFPatients with facial trauma are complex; difficult airway management is often anticipated and challenging for the anaesthetist. Awake tracheal intubation is the gold standard in the management of predicted difficult airway because of its high success rate and safety profile. We present the case of a patient with facial trauma who underwent orotracheal intubation with combined videolaryngoscopy and flexible bronchoscopy, under conscious sedation with intermittent boluses of ketamine and dexmedetomidine.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department Oral and Maxillofacial Surgery, University Hospital Zürich, 8032 Zürich, Switzerland.
Panfacial fractures are complex fractures involving multiple regions of the facial skeleton and may require multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including neurotrauma, which require either immediate (ATLS) airway management, prolonged intubation, or repeated intubations for staged surgeries. The choice of airway for the surgical management of these fractures is difficult, as an assessment of the occlusion is required, and the central nasal complex and/or skull base may be involved, making classical orotracheal or nasotracheal intubation problematic.
View Article and Find Full Text PDFBMJ
December 2024
Department of Anesthesia, Harvard Medical School, Boston, MA 02115, USA.
Objective: To assess whether training provided to an inexperienced clinician just before performing a high stakes procedure can improve procedural care quality, measuring the first attempt success rate of trainees performing infant orotracheal intubation.
Design: Randomized clinical trial.
Setting: Single center, quaternary children's hospital in Boston, MA, USA.
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