MODIFIED TECHNIQUE OF FIBEROPTIC INTUBATION IN A PAEDIATRIC PATIENT WITH TMJ ANKYLOSIS  A CASE REPORT

Mukund Parchandekar; Chandrakant Gharwade; Pankaj Patil; Pradeep Parmar

Volume : VI, Issue : III, March - 2016

MODIFIED TECHNIQUE OF FIBEROPTIC INTUBATION IN A PAEDIATRIC PATIENT WITH TMJ ANKYLOSIS A CASE REPORT

Mukund Parchandekar, Chandrakant Gharwade, Pankaj Patil, Pradeep Parmar

Abstract :

<p>&nbsp;Difficult airway, upper airway obstruction and ventilatory inadequacy added by uncooperativeness in paediatric patients with temporomandibular joint (TMJ) ankylosis demands careful airway assessment and skillful management. In these patients, to avoid technical difficulty and to have safe upper airway access special equipments, techniques, manoeuvres and preparation is needed. Though fiberoptic intubation is gold standard in patients with difficult airway, its unavailability in appropriate sizes may be a problem in some setups. Here, we are reporting fiberoptic technique modified by using an adult fiberoptic onchoscope for successful nasotracheal intubation in a paediatric patient with left TMJ ankylosis. Under sedation and airway anaesthesia and child eathing spontaneously, larynx was visualized with 4.9mm adult fiberoptic onchoscope by transnasal route; and via instrument channel of scope, flexometallic guidewire was advanced into trachea over which 5.5mm plain endotracheal tube was guided after withdrawing onchoscope.</p>