The “impossibly difficult airway” for anesthesiologists and otolaryngologists: a case description

[摘要] The management of difficult airways (DAs) withdyspnea is important for patients with advanced tumorsof the oropharynx and neck. The American Society ofAnesthesiologists’ (ASA) guidelines for the management ofDAs emphasize the use of multiple techniques, includingfacemask ventilation, the awake intubation algorithm,surgical cricothyrotomy/tracheostomy, and extracorporealmembrane oxygenation (ECMO) (1). Practitioners andpatients are assisted by the various guidelines for themanagement of DAs. However, there is a lack of publishedevidence examining whether implementing airwayalgorithms changes clinical practice or patient outcomes.Moreover, there is a lack of consensus on which airwaymanagement approaches should be endorsed. Therefore,we still need to refine and update the guidelines forthe management of DAs. To date, various challengingcases have been reported and solved by anesthesiologistsand otolaryngologists, although differences exist in thetechniques and strategies used for the management ofDAs (2-5). However, the descriptions of the specificDA types, which have not been successfully resolved byanesthesiologists and otolaryngologists except throughECMO, have not been incorporated into standardprotocols. Individual airway management is distinctive inpatients with DAs. Clinical decision-making is supported bypreoperative imaging studies and airway evaluation.

[学科分类] 外科医学