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Awake fiberoptic orotracheal intubation using a modified Guedel airway in a patient with craniocervical instability and an anticipated difficult airway - A case report -
Anesth Pain Med 2018;13(4):383-7
Published online October 31, 2018
© 2018 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Yongjoon Choi, Sung-won Woo, and Ji Heui Lee
Department of Anesthesiology and Pain Medicine, Korea Cancer Center Hospital, Seoul, Korea
Correspondence to: Ji Heui Lee, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Korea Cancer Center Hospital, 75 Nowon-ro, Nowon-gu, Seoul 01812, Korea
Tel: 82-2-970-2820
Fax: 82-2-970-2413
E-mail: jiheui0255@naver.com
ORCID
http://orcid.org/0000-0003-3378-588X
Received February 13, 2018; Revised March 23, 2018; Accepted March 28, 2018.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
In patients with upper cervical instability, airway management may provoke subluxation of the craniocervical region and neurologic injury, and can be challenging for the anesthesiologist. Endotracheal intubation using a fiberoptic bronchoscope is frequently used in these patients to minimize spine motion, but this procedure may fail in patients with altered airway anatomy. When fiberoptic endotracheal intubation fails in these patients, optional intubation methods are limited. We describe successful awake fiberoptic orotracheal intubation using a modified Guedel airway divided in the midline for a 59-year-old man with an anticipated difficult airway, due to limited mouth opening, a nasopharyngeal tumor, and craniocervical spine instability after failure of conventional fiberoptic orotracheal intubation.
Key Words : Airway; Bronchoscope; Guedel airway; Instability; Neck.


October 2018, 13 (4)
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