Arabi Yaseen, Haddad Samir, Al Tuwairgi Othman
Department of Intensive Care Medicine & Division of Maxillofacial, Department of Surgery, King Fahad National Guard Hospital, KAMC, Riyadh, Kingdom of Saudi Arabia.
Middle East J Anaesthesiol. 2006 Jun;18(5):897-902.
Percutaneous tracheostomy has replaced the surgical approach in many intensive care unit patients. In this case report, we present the use of percutaneous tracheostomy on a patient with mandibulo-maxillary interfixation. A 19-year-old male with severe maxillofacial injuries underwent mandibulo-maxillary interfixation. Percutaneous tracheostomy was planned. Because of the mandibulo-maxillary interfixation, however, neither direct laryngoscopy nor the fiberoptic bronchoscopy through the existing preformed nasal endotracheal tube could be utilized. A modified approach utilizing the fiberoptic bronchoscopy to safely withdraw the endotracheal tube was used. The bronchoscope was introduced from the other nostril and used to inspect the withdrawal of the ETT from outside. Our case demonstrates the feasibility of percutaneous tracheostomy in the setting of mandibulo-maxillary interfixation. To our knowledge this is the first report of percutaneous tracheostomy in this indication.
在许多重症监护病房患者中，经皮气管造口术已取代了外科手术方法。在本病例报告中，我们介绍了经皮气管造口术在一名下颌-上颌骨固定患者中的应用。一名19岁的严重颌面损伤男性患者接受了下颌-上颌骨固定术。计划进行经皮气管造口术。然而，由于下颌-上颌骨固定，既无法进行直接喉镜检查，也无法通过现有的预制鼻气管内导管进行纤维支气管镜检查。采用了一种改良方法，利用纤维支气管镜安全地拔出气管内导管。将支气管镜从另一侧鼻孔插入，用于从外部检查气管内导管的拔出情况。我们的病例证明了在进行下颌-上颌骨固定的情况下经皮气管造口术的可行性。据我们所知，这是关于该适应症经皮气管造口术的首例报告。
