Merlo John A, Sadeghipour Hamed
Anesthesiology and Critical Care, Sisters of St. Mary (SSM) Saint Louis University Hospital, St. Louis, USA.
Cureus. 2025 May 25;17(5):e84774. doi: 10.7759/cureus.84774. eCollection 2025 May.
There is minimal research on the true incidence of postoperative neck hematomas following parotidectomy. Managing difficult airways in patients with an anterior neck hematoma requires extreme caution due to the high risk of complete airway collapse. In this case report, a 79-year-old male diagnosed with parotid squamous cell carcinoma underwent a parotidectomy and subsequently developed an anterior neck hematoma as a postoperative complication. Airway management was achieved by maintaining spontaneous ventilation and carefully titrating intravenous and inhaled anesthetics, followed by surgical incision of the hematoma. The use of a video laryngoscope with a D-blade and the initial avoidance of neuromuscular blockade facilitated safe airway control. This case highlights the critical need for prompt intervention in post-parotidectomy neck hematomas and underscores the importance of coordinated efforts between surgical and anesthesia teams. Additionally, strict adherence to established airway management protocols and the application of varied techniques are vital for ensuring positive patient outcomes.
关于腮腺切除术后颈部血肿的真实发生率的研究极少。由于存在气道完全塌陷的高风险,处理颈部前方血肿患者的困难气道需要格外谨慎。在本病例报告中,一名79岁男性被诊断为腮腺鳞状细胞癌,接受了腮腺切除术,随后作为术后并发症出现了颈部前方血肿。通过维持自主通气并仔细滴定静脉和吸入麻醉剂,随后对血肿进行手术切开,实现了气道管理。使用带有D型刀片的视频喉镜并最初避免使用神经肌肉阻滞剂有助于安全地控制气道。本病例突出了对腮腺切除术后颈部血肿进行及时干预的迫切需求,并强调了手术团队和麻醉团队之间协调努力的重要性。此外,严格遵守既定的气道管理方案并应用多种技术对于确保患者获得良好结局至关重要。