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优化广泛口腔外溃疡性病变的麻醉:策略与考量

Optimizing Anesthesia for Extensive Extraoral Fungating Lesions: Strategies and Considerations.

作者信息

Patel Samarpan, Ninave Sanjot, Sagar Shakti

机构信息

Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2024 Jun 12;16(6):e62221. doi: 10.7759/cureus.62221. eCollection 2024 Jun.

Abstract

A large extraoral fungus, frequently seen in late head and neck cancers, poses serious difficulties for the management of anesthesia and surgery. Essential factors include preoperative optimization, airway assessment, intraoperative monitoring, and postoperative care. Risk mitigation and outcome optimization strategies are discussed, including appropriate airway management and hemodynamic monitoring. Ideal patient outcomes in situations of extensive extraoral fungation can be attained by a complete plan that integrates surgical expertise and anesthetic care. This case discusses the successful anesthetic management of a 55-year-old man undergoing composite resection with segmental mandibulectomy, appropriate neck dissection, free fibular flap, and scalp flap for squamous cell carcinoma of the lower labial mucosa with significant extraoral fungation.

摘要

一种大型口外真菌,常见于晚期头颈癌,给麻醉和手术管理带来严重困难。关键因素包括术前优化、气道评估、术中监测和术后护理。讨论了风险降低和结果优化策略,包括适当的气道管理和血流动力学监测。通过整合外科专业知识和麻醉护理的完整计划,可以在广泛口外真菌病的情况下实现理想的患者预后。本病例讨论了一名55岁男性患者的成功麻醉管理,该患者因下唇黏膜鳞状细胞癌伴明显口外真菌病接受了复合切除术,包括节段性下颌骨切除术、适当的颈部清扫术、游离腓骨瓣和头皮瓣。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3db/11244721/57a5c852d13a/cureus-0016-00000062221-i01.jpg

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