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Airway Challenges in Maxillofacial Trauma: A Retrospective Study of 100 Cases
1Anesthesia and Critical Care, Lady Reading Hospital Medical Teaching Institution, Peshawar, PAK.
Introduction:
Maxillofacial trauma creates uniquely challenging airways. Anesthesiologists often struggle with initial access, maintaining the airway during surgery, safe extubation, and postoperative monitoring. These cases require experience and careful planning.
Methods:
This retrospective analysis included 100 patients who were presented with maxillofacial trauma. Patients were assessed for airway patency based on preoperative criteria, including Mallampati classification, thyromental distance, mentohyoid distance, and neck movement. The intubation technique was selected based on fracture type and the anticipated difficulty in securing the airway. Techniques used included direct laryngoscopy, videolaryngoscopy, and blind nasal intubation.
Results:
Direct laryngoscopy was the most commonly used technique in 53% of patients with minimal facial trauma. However, videolaryngoscopy was used in 23% of cases where a difficult airway was anticipated, while blind nasal intubation was performed in 24% of patients. The most common fractures were mandibular (29%), followed by nasal (24%) and maxillary (24%).
Conclusion:
Airway management in maxillofacial trauma patients requires a tailored approach, with videolaryngoscopy being a valuable tool for difficult intubations. Proper preoperative evaluation and the collaboration between anesthesiologists and surgeons are essential for optimizing patient outcomes.
