Senders C W, Eisele J H
Department of Otolaryngology, University of California, Davis, USA.
Int J Pediatr Otorhinolaryngol. 1995 Aug;33(1):53-60. doi: 10.1016/0165-5876(95)01192-e.
Airway obstruction from tongue edema following intraoral procedures is uncommon. However, the insidious nature of postoperative lingual edema and the gravity of acute airway obstruction requires diligent monitoring by the surgeon. The etiology of lingual edema is likely related to tissue ischemia, secondary to venous or arterial obstruction. This study shows that during normal usage the mouthgag can easily generate pressures which typically exceed venous pressure and often exceeds arterial pressure. Suspension of the mouthgag almost always exceeds arterial pressure. Whether that pressure is transferred to the respective arteries and veins is likely highly variable and relates to the patient's individual dentofacial anatomy. Avoidance of these high pressures should minimize the risk of postoperative lingual edema. The U.C. Davis Mouthgag Usage Protocol is presented.
口腔内手术后因舌部水肿导致气道阻塞的情况并不常见。然而，术后舌部水肿的隐匿性以及急性气道阻塞的严重性要求外科医生进行密切监测。舌部水肿的病因可能与静脉或动脉阻塞继发的组织缺血有关。本研究表明，在正常使用过程中，口咽通气道很容易产生通常超过静脉压且常常超过动脉压的压力。口咽通气道的悬吊几乎总是超过动脉压。该压力是否传递到相应的动脉和静脉可能差异很大，并且与患者个体的牙颌面解剖结构有关。避免这些高压应可将术后舌部水肿的风险降至最低。本文介绍了加州大学戴维斯分校口咽通气道使用方案。
