• Nobuyasu Komasawa, Ryusuke Ueki, Yohei Iwasaki, Tsuneo Tatara, Chikara Tashiro, and Yoshiroh Kaminoh.
• Department of Central Surgical Center, Hyogo College of Medicine, Nishinomiya 663-8501.
• Masui. 2012 Oct 1;61(10):1125-7.

AbstractA 79-year-old man was diagnosed with maxillary cancer and underwent total maxillectomy under general anesthesia. The oropharyngeal airway was needed for efficient mask ventilation during anesthesia induction. The maxilla was totally resected and reconstructed with skin from a femoral flap. Tracheal extubation was considered to be difficult given that mask ventilation was contraindicated due to reconstruction of the maxilla. After inserting a tube exchanger (TE) into the trachea, the tracheal tube was exchanged with an air-Q laryngeal airway through the TE. After confirming effective ventilation with the air-Q mask, the patient was awakened from anesthesia. We confirmed sufficient spontaneous breathing and no active bleeding in the pharynx. After re-inserting the TE thorough air-Q, the air-Q was removed, followed by removal of the TE. These findings suggest that the air-Q and TE were effective in a case of difficult extubation after maxillectomy.

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