title: Unanticipated difficult nasotracheal extubation following oral surgery.
abstract: Difficult tracheal extubation is a rare but potentially dangerous problem that can be life threatening especially when it is unexpected and there is a lack of preparation. Most of these cases are associated with orofacial surgery. We herein present two patients with oral cavity cancer who experienced unexpected postoperative difficult nasotracheal extubation by a Kirschner pin penetrating the endotracheal tube and fixing the tube at the maxillary bone following tumor resection. The pins were found by fiberoptic bronchoscopy. Both patients were returned to the operating theater immediately for removal of the penetrating pins as well as the endotracheal tubes. The common causes of difficult tracheal extubation and strategies of managing these situations are discussed in the article.
authors: Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan, ROC.
authors: Suet-Li
authors: SL
authors: Leong
authors: Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan, ROC.
authors: Yao-Tsung
authors: YT
authors: Lin
authors: Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan, ROC.
authors: Chung-Hsi
authors: CH
authors: Hsing
authors: Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan, ROC.
authors: Kuo-Mao
authors: KM
authors: Lan
authors: Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan, ROC; Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan, ROC. Electronic address: mygegon@kimo.com.
authors: Ming-Chung
authors: MC
authors: Lin
mesh_terms: D000369:Aged, 80 and over; D060666:Airway Extubation / Q000379:methods*; D001999:Bronchoscopy / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery
keywords: Kirschner pin; bronchoscopy; extubation; oral cavity cancer