• J Longás Valién, J Martínez Ubieto, L Muñoz Rodríguez, S Ortega Lucea, L M Guerrero Pardos, E Vicente González, and N Quesada Gimeno.
• Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario Miguel Servet, Zaragoza. jalonva@terra.es
• Rev Esp Anestesiol Reanim. 2005 Mar 1;52(3):149-53.

ObjectiveTo assess the level of intubation difficulty and anatomical changes after hyoid surgery. To evaluate the difficulty of switching from nasotracheal to orotracheal intubation after hyoid and palatopharyngeal surgery using an exchanger.Material And MethodsProspective study enrolling 30 patients undergoing surgery for obstructive sleep apnea syndrome (OSAS) in 2 consecutive phases. Anatomical features suggesting risk of difficult intubation, anatomical changes caused by surgery, the incidence of failure to intubate upon first attempt during the first surgical session, and upon switching from nasal to oral intubation, and the time required to intubate were recorded. The rate of complications during and after surgery was also noted.ResultsThe incidence of difficult intubation was 15% and no complications developed in the switch from nasotracheal to orotracheal intubation (100% success rate).ConclusionNew surgical treatments for the OSAS patient require new anesthetic maneuvers such as nasotracheal-orotracheal intubation exchange after hyoid surgery. The exchanger used in the present study offers a valid way to achieve airway management in this situation.

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