Prone positioning for head and neck reconstructive surgery.
Certain head and neck surgical cases require the patient to be positioned prone. Such positioning carries with it an attendant subset of risks and complications not otherwise encountered in more traditional supine positioning. Gaining awareness of these risks and complications, and developing proactive positioning strategies, will enable the surgical team to position the patient optimally for the procedure and provide for every consideration of patient safety. This article consists of a specific literature review of those issues directly related to the anatomical and physiological concerns arising from prone positioning. Particular attention is paid to the cardiopulmonary, renal, ophthalmologic, and neurological vulnerabilities unique to this position. Proper planning by the surgical team and utilization of the correct equipment are a necessity. A tailored approach to the needs of the individual patient and an intimate awareness of the potential pitfalls will contribute to better outcomes when using the prone position.
Mobley
Steven Ross
SR
Division of Otolaryngology, Department of Surgery, University of Utah, 50 N. Medical Drive, 3C-120, Salt Lake City, Utah 84107, USA. steven.mobley@hsc.utah.edu
Miller
Brian Thomas
BT
Astor
Frank C
FC
Fine
Bradley
B
Halliday
N James
NJ
D001794:Blood Pressure / Q000502:physiology; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D011300:Preoperative Care; D016684:Prone Position / Q000502:physiology*; D014109:Total Lung Capacity / Q000502:physiology