DOI: 10.36347/sjams.2016.v04i10.028

Pages: 3697-3701

Anaesthetic management of patients with head and neck carcinomas (HNC) is challenging because of the risk involved in their airway management due to associated anatomic and physiologic changes as well as complications arising from radiotherapy and chemotherapy. The aim of this study was to conduct a retrospective analysis of modalities of airway management in patients undergoing HNC surgeries. Medical records of 104 patients, treated from January 2012 to December 2013 were reviewed for airway management in the perioperative period. Out of 104 patients who presented with HNC, 52 patients were managed conservatively which included both chemotherapy and radiotherapy. 52 patients were treated surgically which included wide excision with or without reconstructive procedures. Mouth opening was restricted in 52% of patients due to malignancy. 29% of patients had Modified Mallampati class III and 26% had class IV. 67 % patients were intubated by conventional direct laryngoscopy and 23 %( 12) were intubated using fibreoptic bronchoscope. Elective tracheostomy was performed in 1 patient preoperatively and in 1 postoperatively. 66 %( 34) of patients were extubated immediately after the procedure. Malignancies involving head and neck are a potential for difficult airway scenario. Proper planning and management during the perioperative period reduces the morbidity in these patients. Nasotracheal intubation is the preferred technique of airway management in most of these cases, thus decreasing the need for and complications associated with tracheostomy.