title: Cuffed oropharyngeal airway for difficult airway management.
abstract: Difficulties with airway management are often caused by anatomic abnormalities due to previous oral surgery. We performed general anesthesia for a patient who had undergone several operations such as hemisection of the mandible and reconstructive surgery with a deltopectoralis flap, resulting in severe maxillofacial deformation. This made it impossible to ventilate with a face mask and to intubate in the normal way. An attempt at oral awake intubation using fiberoptic bronchoscopy was unsuccessful because of severe anatomical abnormality of the neck. We therefore decided to perform retrograde intubation and selected the cuffed oropharyngeal airway (COPA) for airway management. We inserted the COPA, not through the patient's mouth but through the abnormal oropharyngeal space. Retrograde nasal intubation was accomplished with controlled ventilation through the COPA, which proved to be very useful for this difficult airway management during tracheal intubation even though the method was unusual.
authors.affiliation: Assistant Professor, The University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Takaishi
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawahito
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Tomioka
authors.forename: Satoru
authors.initials: S
authors.lastname: Eguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitahata
mesh_terms: D000368:Aged; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods; D000768:Anesthesia, General; D001999:Bronchoscopy / Q000379:methods; D016292:Procedural Sedation / Q000379:methods; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008334:Mandible / Q000601:surgery; D055100:Optical Fibers; D009960:Oropharynx; D019651:Plastic Surgery Procedures / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods; D013524:Surgical Flaps / Q000637:transplantation
keywords: Cuffed oropharyngeal airway; Difficult airway management