title: Use of the flexible intubating fibrescope for tracheal re-intubation in a patient with difficult extubation.
abstract: Difficulty in tracheal extubation was experienced in a patient following major maxillofacial surgery for reconstruction of the maxilla using bone grafts and a microvascular free flap. With the aid of an intubating flexible fibrescope, the cause of the difficulty was identified as a stitch accidentally transfixed through the tracheal tube. Tracheal re-intubation was required to facilitate surgical exploration to remove the stitch and the proximal end of the tube. The tip of an Olympus LF-2 intubating fibrescope was successfully negotiated in the trachea alongside the original tube with its cuff deflated. This allowed safe and speedy railroading of a new tube immediately after the distal end of the original tube was removed.
authors.affiliation: Department of Maxillo-facial Surgery, Oxford Radcliffe Hospital, UK.
authors.forename: M T
authors.initials: MT
authors.lastname: Popat
authors.forename: R M
authors.initials: RM
authors.lastname: Dravid
authors.forename: S R
authors.initials: SR
authors.lastname: Watt-Smith
mesh_terms: D000328:Adult; D005336:Fiber Optic Technology / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D008437:Maxilla / Q000601:surgery*; D013537:Sutures