Dentistry

Airway management in post chemoradiotherapy head & neck cancer patients presenting for dental procedures inambulatory setting - case series

15^th Euro Congress on Dental & Oral Health

October 24-26, 2016 Rome, Italy

Anum Aijaz

Aga Khan University Hospital

Posters & Accepted Abstracts: Dentistry

Abstract:

Introduction: A wide range of potentially debilitating dental complications may occur as a consequence of postoperative chemoradiotherapy such as oral mucositis, dental caries, trismus and osteoradionecrosis of the mandible with the dead bone exposed and liable to infection or even pathological fracture. Dental complications of chemoradiation in head and neck cancer patients often require surgical treatment under general anaesthesia. Patients usually scheduled as day care basis that warrants early discharge. Most of these have very limited mouth opening or distorted anatomy of face as a result of previous surgery and radiation. Airway management remains central to perioperative care. Case series: Five patients scheduled for dental procedures under general anaesthesia were selected. The selected patients were identified on preoperative assessment at an increased risk of difficult airway and fiberoptic intubation was planned. Awake fiberoptic intubation was done in two patients while three were intubated after inducing general anaesthesia. Regional anaesthesia of airway was achieved with lignocaine 4% nebulization and spray as you go technique. The other three patients were selected for asleep fiberoptic intubation based on the fact that they have no anatomical distortion that create problems with bag mask ventilation and no signs of airway obstruction. All patients underwent 30-45 minutes dental procedures. Patients were extubated and discharged after 1 hour from recovery room and 3 hours after day care ward. No postoperative problems related to airway management were encountered. Conclusion: Increasing number of these patients present to us for dental extractions and restorative procedures under general anaesthesia as day care procedures. Present case series highlights some important aspects regarding management of anticipated difficult airways in ambulatory setting.

Biography :

Dr. Anum Aijaz has completed her BDS in 2011 December from Liaquat University of Medical and Health Sciences, Jamshoro Hyderabad and has been currently working as a Dental/Medical Officer in Aga Khan University, Karachi.

Email: anum.aijaz@aku.edu