Advertisement

The Role of Surgical Airway Access

  • Kerstin M. Stenson
Chapter

Abstract

Anesthesiologists and head and neck surgeons traditionally have embodied the phenomenon of collegial interactions, and few professional interactions are more rewarding than those that result in successful management of a patient with a difficult airway. In these situations, the difficult airway becomes a shared challenge that demands mutual trust and cooperation between otolaryngologist and anesthesiologist [1]. Pre-intubation communication is mandatory, with arrangements of intubation details and contingency plans outlined. This chapter will focus on how the head and neck surgeon can aid the anesthesiologist during the perioperative care of a patient with a challenging airway.

Keywords

Obstructive Sleep Apnea Endotracheal Tube Recurrent Laryngeal Nerve Difficult Airway Tracheotomy Tube 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Sofferman R, Johnson D, Spencer R. Lost airway during anesthesia induction: alternatives for management. Laryngoscope. 1997;107:1476–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Davies R, Balachandran S. Anterior commissure laryngoscope. Anaesthesia. 2003;58:721–2.PubMedCrossRefGoogle Scholar
  3. 3.
    Zeitels S. Chevalier Jackson’s contributions to direct laryngoscopy. J Voice. 1998;12:1–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Riazi S, Karkouti K, Heggie J. Case report: management of life-threatening oropharyngeal bleeding with recombinant factor VIIa. Can J Anaesth. 2006;53:881–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Holinger P. An hour-glass anterior commissure laryngoscope. Laryngoscope. 1960;70:1570–1.PubMedGoogle Scholar
  6. 6.
    Conacher I, Curran E. Local anaesthesia and sedation for rigid bronchoscopy for emergency relief of central airway obstruction. Anaesthesia. 2004;59:290–2.PubMedCrossRefGoogle Scholar
  7. 7.
    Wain J. Rigid bronchoscopy: the value of a venerable procedure. Chest Surg Clin N Am. 2001;11:691–9.PubMedGoogle Scholar
  8. 8.
    Linscott M, Horton W. Management of upper airway obstruction. Otolaryngol Clin North Am. 1979;12:351–73.PubMedGoogle Scholar
  9. 9.
    Rodricks MB, Deutschman CS. Emergent airway management. Crit Care Clin. 2000;16:389–409.PubMedCrossRefGoogle Scholar
  10. 10.
    Weymuller E. Acute airway management. In: Cummings CW, editor. Otolaryngology-head and neck surgery. 2nd ed. St. Louis, MO: CV Mosby Publishing Co; 1986. p. 2382–95.Google Scholar
  11. 11.
    Burkey B, Esclamado R, Morganroth M. The role of cricothyroidotomy in airway management. Clin Chest Med. 1991;12:561–71.PubMedGoogle Scholar
  12. 12.
    DeLaurier G, Hawkins M, Treat R, et al. Acute airway management. Role of cricothyroidotomy. Am Surg. 1990;56:12–5.PubMedGoogle Scholar
  13. 13.
    Gillespie M, Eisele D. Outcomes of emergency surgical airway procedures in a hospital-wide setting. Laryngoscope. 1999;109:1766–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Isaacs J, Pedersen A. Emergency cricothyroidotomy. Am Surg. 1997;63:346–9.PubMedGoogle Scholar
  15. 15.
    DiGiacomo J, Angus L, Simpkins C, et al. Safety and efficacy of the rapid four-step technique for cricothyroidotomy using a Bair claw [letter]. J Emerg Med. 2001;20:303–4.CrossRefGoogle Scholar
  16. 16.
    Davis D, Bramwell K, Hamilton R, et al. Safety and efficacy of the rapid four-step technique for cricothyroidotomy using a Bair Claw. J Emerg Med. 2000;19:125–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Hatton K, Price S, Craig L, et al. Educating anesthesiology resident to perform percutaneous cricothyroidotomy, retrograde intubation, and fiberoptic bronchoscopy using preserved cadavers. Anesth Analg. 2006;103:1205–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Wenig B, Applebaum E. Indications for and techniques of tracheotomy. Clin Chest Med. 1991;12:545–53.PubMedGoogle Scholar
  19. 19.
    Moorthy S, Gupta S, Laurent B, et al. Management of airway in patients with laryngeal tumors. J Clin Anesth. 2005;17:604–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Altman K, Waltonen J, Kern R. Urgent surgical airway intervention: a 3 year county hospital experience. Laryngoscope. 2005;115:2101–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Burtner D, Goodman M. Anesthetic and operative management of potential upper airway obstruction. Arch Otolaryngol. 1978;104:657–61.PubMedCrossRefGoogle Scholar
  22. 22.
    Goldenberg D, Gov Ari E, Golz A, et al. Tracheotomy complication: a retrospective study of 10020 cases. Otolaryngol Head Neck Surg. 2000;123:495–500.PubMedCrossRefGoogle Scholar
  23. 23.
    Myers E, Carrau M. Early complications of tracheotomy. Clin Chest Med. 1991;12:589–95.PubMedGoogle Scholar
  24. 24.
    Saini S, Taxak S, Singh M. Tracheostomy tube obstruction caused by an overinflated cuff. Otolaryngol Head Neck Surg. 2000;122:768–9.PubMedCrossRefGoogle Scholar
  25. 25.
    McGuire G, El-Beheiry H, Brown D. Loss of the airway during tracheostomy: rescue oxygenation and re-establishment of the airway. Can J Anaesth. 2001;48:697–700.PubMedCrossRefGoogle Scholar
  26. 26.
    Patel K, Zdanski C. Cricothyroidotomy vs. sternal tracheotomy for challenging airway anatomy. Laryngoscope. 2008;118:1827–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Gross N, Cohen J, Anderson P, et al. “Defatting” tracheotomy in morbidly obese patients. Laryngoscope. 2002;112:1940–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Professor of Surgery, Department of Surgery/Section of Otolaryngology—Head and Neck SurgeryThe University of ChicagoChicagoUSA

Personalised recommendations