A case of displaced mandibular reconstruction plate and the airway

Ashani Ratnayake Saman Nanayakkara Manjula Herath

Keywords: Difficult airway, Oro-maxillary-facial surgeries, Fiberoptic intubation, Mandibular reconstruction

Abstract

Difficult airway is a common problem encountered in oro-maxillo-facial surgeries. We describe a case where a displaced mandibular reconstruction plate obstructing the access to oral cavity. The airway was further compromised by previous tracheostomy, and limited neck extension owing to previous surgeries and radiotherapy. The inability of the patient to swallow increased the risk of pulmonary aspiration. The first line of airway management in such patient should be fibro-optic laryngoscopy. However, one must have alternative plans for securing airway if there are expected difficulties with fiberoptic laryngoscopy. Such plans were made considering her clinical presentation. We believe this case highlights the importance of pre-planning the strategies for airway management according to the presentation.

Key words: Difficult airway; Oro-maxillary-facial surgeries; Fiberoptic intubation; Mandibular reconstruction

Citation: Ratnayake A, Nanayakkara S, Herath M. A case of displaced mandibular reconstruction plate and the airway. Anaesth. pain intensive care 2022;27(1):139−141; DOI: 10.35975/apic.v27i1.2126

Received: September 24, 2022; Reviewed: November 15, 2022; Accepted: November 15, 2022

Author Biographies

Ashani Ratnayake

Consultant Anesthetist/ Lecturer in anesthesiology and Critical care, Faculty of Medicine, University of Peradeniya, Sri Lanka

Saman Nanayakkara

Consultant Anesthetist/ Senior Lecturer in Anesthesiology and Critical care, Faculty of Medicine, University of Peradeniya, Sri Lanka

Manjula Herath

Consultant Oro-maxillary facial surgeon, Base Hospital Diyathalawa, Sri Lanka

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