Management airway in patients with facial trauma – a retrospective study-

Abstract

Background & Aim: Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, and gunshot wounds. Any flaw in airway management may lead to grave  mortality in prehospital or hospital settings and as well as for reconstruction of fractures.

Materials & Methods: 67 patients of maxillofacial injuries, operated over a period of two years during June 2016 to July 2018 in Al-moasa   hospital were reviewed. All patients were reviewed in depth with age related type of injury, etiology and techniques of airway management.

Results: The major etiology of injuries were gun shot injuries (71.64%) followed by road traffic accidents (22.38%). Majority of patients were young in the age group of 11-30 years (79 %). Complicated  Fracture (31.34%) was the most common injury, followed by  mandible fracture (28.36%). Several methods available for securing the airway are important in such circumstances. Airway secured by fiberoptic bronchoscopic nasal intubation in 27% of patients, oral intubation (19%)،  by nasal intubation with direct visualization of vocal cords was (15%), by. Other methods like blind nasal intubation was avoided.

Conclusion: The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the possibility of leaving the patient without wiring an open mouth and alternative techniques like fiberoptic bronchoscopic intubation, it is unnecessary to carry out tracheostomy for securing the airway as frequently as in the past.