CLINICAL AND EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH DIFFICULT INTUBATION IN MAXILLOFACIAL SURGERY AND STOMATOLOGY.

Authors

  • RAKOTONOMENJANAHARY NMP Service d’Anesthésie ET de Réanimation du Centre Hospitalier Universitaire Joseph Dieudonnée Rakotovao (CHUJDR) Antananarivo Madagascar
  • RAHANITRINIAINA Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
  • RAZAFINDRAINIBE Service de Réanimation du Centre Hospitalier Universitaire Gynéco – Obstetrique Befelatanana (CHUGOB) Antananarivo Madagascar
  • DRIAMANDRATO AT Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar
  • RAJAONERA Service de Réanimation du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA) Antananarivo Madagascar

DOI:

https://doi.org/10.53555/eijmhs.v6i1.132

Keywords:

chirurgie maxillo – faciale, critère prédictif, intubation difficile

Abstract

Aim of the work: To describe clinical and epidemiological profile of patients with difficult intubation in maxillofacial surgery and stomatology.

Methods: This is a descriptive retrospective study over a period of two years (April 2017 to May 2019) at the University Hospital Joseph Dieudonné Rakotovao (CHU - JDR)

Antananarivo. This includes all patients whose intubation lasted more than 10 minutes and / or more than three attempts, or could not be performed.

Results: Twenty-eight (28) patients were collected with difficult intubation rate of 8%. A male predominance was found (sex ratio = 2.25) and the lesions are mainly of tumoral origin (54%), sitting at the level of the mandible (43%) and locating on the right side (54%). The classification of Mallampati and measurement of mouth opening could not be evaluated in 39% and 18% of cases respectively. For the classic criteria that were able to evaluate: the classification of mallampati III and IV = 59%, the mouth opening less than 3.5 cm = 26% and the mento - thyroid distance less than 6cm = 4%.

Conclusion: Although the classical predictive criteria for difficult intubation are reliable, they cannot always be correctly assessed in maxillofacial surgery. And particular features of the lesion have been found in patients who presented with difficult intubation. Hence the interest of carrying out an analytical study in order to elaborate a predictive score based on the classic criteria and  the characteristics of      the lesion. 

References

. Bourgain J-L. Intubation difficile en chirurgie cervicofaciale. Prat En Anesth Réanimation. sept 2009;13(4):291-

. Tuzuner-Oncul AM., Kucukyavuz Z. Prevalence and prediction of difficult intubation in maxillofacial surgery

patients. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. août 2008; 66(8):1652-8.

. Boisson-Bertrand, Bourgain JL, Camboulives J, Crinquette V, Cros AM, Dubreuil M, et al. Intubation difficile:

Société française d’anesthésie et de réanimation Expertise collective. Ann Fr Anesth Réanimation. 1 janv

;15(2):207-14.

. Cros A-M. Réactualisation de la conférence d’experts sur l’intubation difficile : et après ? Ann Fr Anesth

Réanimation. janv 2008;27(1):1-2.

. Roth D, Pace NL, Lee A, Hovhannisyan K, Warenits AM, Arrich J, et al. Bedside tests for predicting difficult

airways: an abridged Cochrane diagnostic test accuracy systematic review. Anaesthesia [Internet]. 6 mars 2019 ;

Disponible sur: http://doi.wiley.com/10.1111/anae.14608

. Soydan SS, Bayram B, Akdeniz BS, Kayhan Z, Uckan S. Changes in difficult airway predictors following

mandibular setback surgery. Int J Oral Maxillofac Surg. nov 2015;44(11):1351-4.

. Mohamedbhaia H, Ali S, Dimasia I, Kalavrezosa N. TRACHY score: a simple and effective guide to management

of the airway in head and neck cancer. Br J Oral Maxillofac Surg. 1 oct 2018;56(8):709-14.

. Wahal R. Temporo-mandibular joint ankylosis – The difficult airway. J Oral Biol Craniofacial Res. mai

;5(2):57-8.

. Maes J-M, Raoul G, Omezzine M, Ferri J. Ostéites des os de la face. EMC - Stomatol. sept 2005;1(3):208‑30

Downloads

Published

2020-03-27