Danica Markovic

University Clinical Center in Nis, Serbia

Title: Successful Fiberoptic Intubation Of A Difficult Airway Due To Parotid Gland Tumor And Limited Mouth Opening Augmented By The Use Of Bougie As A Guide

Time:

---

Biography

Danica Markovic was born on November the 4^th 1983. in Nis, Serbia. She completed her medical degree in 2009 on the Medical Faculty, University in Nis, Serbia. She is currently on her PhD studies with a project which considers the cooperation between surgeons and anesthetists in ENT surgery. During her scientific career she has participated in multiple projects, was an author of many publications and presented on many national and international conferences. She is working as an anesthesiologist on the ENT Clinic, University Clinical Center in Nis, Serbia since July 2021. 

Research Intrest

Abstract

 

We represent a case report of a 63-year old patient with retro- and submandibular tumor, with preoperatively predicted difficult and/or impossible mask ventilation and intubation.

The patient had three out of four predictors of difficult mask ventilation and four indicators of difficult intubation. Among other parameters which indicated difficult intubation (increased neck length and girth and limited neck mobility), we would like to highlight that the patient had an inter incisor gap limited to 0.9 cm. The method of intubation we used was orotracheal fiberoptic intubation of a patient under general anesthesia, with bougie used as a guide. Induction agents were administered in boluses in order to timely assess ventilation difficulty, after which the short acting muscle relaxant was used. The use of any “mouth opening devices” was not possible, therefore, the bougie was introduced into pharynx and used as an indicator that we have reached the pharyngeal level. The bougie was used again as a possible guide to trachea after extubation.

It is unusual in everyday practice to provide fiberoptic intubation of a patient under general anesthesia, especially in cases where there is a high risk of difficult and/or impossible intubation. We consider the presented method efficient and safe in patients with limited inter incisor gap in ENT surgery.