Sundaram Subbulakshmi, Ramdas Gowthaman, Paul Anisha Pauline, Krishnasamy Sekaran Natesan
Department of Anaesthesiology, Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India.
Anesth Essays Res. 2017 Jul-Sep;11(3):787-789. doi: 10.4103/0259-1162.186612.
Oral and maxillofacial surgeries associated with complications due to endotracheal tube (ETT) damage are being reported in literature increasingly. In this case, we report a rare case of accidental perforation of a flexometallic ETT intraoperatively during an orthognathic corrective surgery, in a 19-year-old female patient in whom submental intubation had been performed. The complication was managed conservatively as the tissue debris created during the osteotomy drilling occluded the damage and caused a good seal of the damage, with minimal leak, and no airway compromise. The purpose of this article is to highlight these hazards and discuss alternative airway management approaches so that anesthesiologists can recognize these complications and be prepared to deal with them in a proper manner.
文献中越来越多地报道了与气管内插管（ETT）损伤相关并发症的口腔颌面外科手术。在此病例中，我们报告了一例罕见的术中意外穿孔事件，发生在一名19岁接受颏下插管的女性患者的正颌矫正手术中，其可弯曲金属ETT出现穿孔。由于截骨钻孔过程中产生的组织碎片堵塞了损伤处，实现了损伤处的良好密封，泄漏极少且未造成气道受损，因此对该并发症采取了保守处理。本文的目的是强调这些风险并讨论替代气道管理方法，以便麻醉医生能够识别这些并发症并做好妥善处理的准备。
