Department of Oral and Maxillofacial Surgery, VSPM Dental College, Nagpur, India.
Department of Oral and Maxillofacial Surgery, VSPM Dental College, Nagpur, India -
Minerva Surg. 2021 Apr;76(2):173-178. doi: 10.23736/S2724-5691.20.08354-6. Epub 2020 Aug 6.
Maxillofacial trauma is complex kind of injury that requires complex treatment, hence it is difficult in selecting the type of intubation technique depending on trauma. With the advent of various technologies and devices, surgeon and anesthetist should select right method of intubation that will benefit patient.
In a retrospective study, patients of either sex, admitted in Lata Mangeshkar Hospital under Oral and Maxillofacial Surgery unit for treating maxillofacial trauma operated during year 2018 to year 2019 as elective basis were studied.
Of 78 patients, the majority (37, 47.4%) were in the 21-30 age group, followed by the young adults 31-40 years age group (19, 24.3%). Mandible fracture was found to be the most common injury in 35 patients (44.3%) followed by fracture zygoma in 26(33.3%) patients and panfacial in eight patients (10.2%). There was frontal bone fracture in three patients (3.8%). Fiberoptic intubation under sedation was carried out in 34 (43.5%) and submental intubation in 20 (25.6%) and nasal intubation with direct visualization of vocal cords in 14 (17.9%) and blind nasal intubation was performed in eight (10.2%).
The results of this study suggest that the old concept of securing the airway in difficult situation by tracheostomy should be revised.
颌面创伤是一种复杂的损伤,需要复杂的治疗,因此根据创伤选择插管技术的类型很困难。随着各种技术和设备的出现,外科医生和麻醉师应选择对患者有益的正确插管方法。
在一项回顾性研究中,研究了 2018 年至 2019 年期间以择期为基础在拉塔·曼格什卡尔医院口腔颌面外科病房接受治疗颌面创伤的男女患者。
在 78 名患者中,大多数(37,47.4%)年龄在 21-30 岁之间,其次是年轻成年人 31-40 岁年龄组(19,24.3%)。下颌骨骨折是最常见的损伤,有 35 例(44.3%),其次是颧骨骨折 26 例(33.3%)和全颜面骨折 8 例(10.2%)。有 3 例患者(3.8%)有额骨骨折。在 34 例患者中进行了镇静状态下纤维光导插管(43.5%),20 例患者进行了颏下插管(25.6%),14 例患者进行了直接观察声带的鼻插管(17.9%),8 例患者进行了盲目鼻插管(10.2%)。
本研究结果表明,应修改在困难情况下通过气管切开术确保气道的旧观念。