Management and maintenance of the airway in cervical XXXX : a retrospective analysis of 15 cases.

@entity1 @entity1337 @entity281 @entity148 @entity158 @entity2827 @entity9156
Cervical @entity9156 is a progressive @entity281 of the neck associated with high mortality, and skillful management of the airway is critical for operations under general anaesthesia. Tracheostomy under local anaesthesia has been considered the gold standard of airway management in @entity1 with @entity281 , but it may be difficult or impossible in advanced cases. We report here our experience over 6 years (January 2008 and December 2013) during which a total of 15 @entity1 was diagnosed with cervical @entity9156 . Of 6 @entity1 , admitted between January 2008 and March 2010, 5 had routine tracheostomy under local anaesthesia, 1 had direct laryngoscopy intubation, and 9 who were admitted between Spring 2010 and December 2013 were treated with nasotracheal intubation. Postoperatively all @entity1 were given moderate sedation and @entity1337 . Nasotracheal intubation was continued until the @entity281 had been controlled. During intubation patency of the endotracheal tube was maintained by humidification with a continuous pump of 0.45% @entity2827 and suction. All 15 @entity1 (10 @entity1 and 5 @entity1 , mean age 62 years, range 36-93) required an emergency drainage procedure under general anaesthesia. Fourteen of the 15 had evidence of compromise of the airway, but emergency intervention was not required. Since Spring 2010, 9 consecutive @entity1 had required nasotracheal intubation, including 7 video laryngoscopies and 2 fibreoptic bronchoscopies. No other interventions were required. @entity1 were intubated postoperatively from 3 to 14 days, and there were no problems with the airway. Advanced techniques for control of the airway have a high rate of success in @entity1 with @entity9156 and could be an appropriate alternative to a traditional airway. Postoperative sedation and @entity1337 should be considered as routine management of @entity158 and @entity148 .
