• J Clin Anesth · Nov 2016

    Case Reports

    Transorbital endotracheal intubation: a nonstandard approach to a difficult airway.

    • Nathan H Waldron, Bryant W Stolp, Michael P Ogilvie, David B Powers, and Michael R Shaughnessy.
    • Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA. Electronic address: nathan.waldron@dm.duke.edu.
    • J Clin Anesth. 2016 Nov 1; 34: 314-7.

    AbstractWe present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. Given his limited mouth opening, the surgeon requested a nasal endotracheal tube. Because of concerns of traumatizing his nare, we utilized a flexible fiberoptic bronchoscope to perform asleep transorbital intubation. Airway management in patients with severe trismus may require ingenuity.Copyright © 2016 Elsevier Inc. All rights reserved.

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