Journal of Scientific Dentistry

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VOLUME 1 , ISSUE 2 ( July-December, 2011 ) > List of Articles

CASE REPORT

Oral Submucous Fibrosis: Dealing with A difficult Airway - A Case Report

Sujee C, Ramesh C, Suresh V, Jeelani S

Keywords : Airway management, Fiberoptic intubation, Oral Submucous Fibrosis

Citation Information : C S, C R, V S, S J. Oral Submucous Fibrosis: Dealing with A difficult Airway - A Case Report. 2011; 1 (2):38-45.

DOI: 10.5005/jsd-1-2-38

License: CC BY-NC 4.0

Published Online: 01-12-2011

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

When faced with an anticipated difficult airway, we need to consider securing the airway in an awake state without using anaesthetic agents and muscle relaxants. Awake fiberoptic intubation is a non- invasive technique of securing airway in such patients. This case resport discusses the anesthetic management of a 28 year old man with Oral Submucous Fibrosis where tracheostomy was avoided with the use of awake fiberoptic intubation. Awake fiberoptic intubation under topical anesthesia may be the ideal method to secure the airway in advanced cases of Oral Submucous Fibrosis. As the procedure can be highly discomforting, the patient has to be prepared psychologically and pharmacologically for awake intubation. When fiberoptic bronchoscopy is not feasible, not available or has failed, an awake tracheostomy may be the preferred option.


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  1. Schwartz J. Atrophia Idiopathica Mucosae Oris. London: Demonstrated at the 11th Int Dent Congress; 1952.
  2. Joshi SG. Submucous Fibrosis of The Palate and Pillars. Ind J Otolaryng 1953;4:1-4.
  3. Canniff JP, Harvey W, Harris M. Oral submucousfibrosis: its pathogenesis and management. Br Dent J 1986;160(12):429-34.
  4. Mahajan R, Jain K, Batra Y.K. Submucous fibrosis secondary to chewing of quids: another cause of unanticipated difficult intubation. Can J Anesth 2002;49:309-11.
  5. Eipe N. The Chewing of Betel Quid and Oral Submucous Fibrosis and Anesthesia. Anesth Analg 2005;100:1210-3.
  6. Paymaster JC. Cancer of the buccal mucosa: a clinical study of 650 cases in Indian patients. Cancer 1956;9:431-5.
  7. Pindborg JJ. Is submucous fibrosis a precancerous condition in the oral cavity? Int Dent J 1972;22:474-80.
  8. Shah B, Lewis MAO, Bedi R. Oral submucous fibrosis in an 11-year-old Bangladeshi girl living in the United Kingdom. Br Dent J 2001;191:130- 2.
  9. Ramkumar V Prepation of the patient and airway for awake intubation. Indian J Anaesth 2011;55:442-7.
  10. Merchant AT, Haider SM, Firkee FF. Increased severity of oral submucous fibrosis in young Pakistani men. Br J Oral Maxillofacial Surg 1997;35:284-7.
  11. Stone DJ, Gal TJ. Airway management. In: Miller RD, editors. Anesthesia, 5th ed. Philadelphia: Churchill Livingstone; 2000: pp 1414-51.
  12. Allen PW, Osman HG. Submucous fibrosis (Letter). Anaesthesia 1988;43:809-10.
  13. Caplan RA, Benumof JL, Berry FA, et al. Practice guidelines for management of the difficult airway. A report by the American Society of Anesthesiologists Task Force on management of the difficult airway. Anesthesiology 1993;78:597-602.
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