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129466

Awake Nasal Fiberoptic Intubation in Diffuse Para-pharyngeal Abscess

Article

Last updated: 03 Jan 2025

Subjects

-

Tags

Bronchology and Esophagology

Abstract

This is a case report on awake fibreoptic intubation for a patient with a deep neck space infection. Intubation in this group of patients is considered difficult. It is challenging to anaesthesiologists, emergency physicians and otorhinolaryngologists because there is no consensus for airway management in these patients. We present a 30-year-old gentleman with swelling over the right cheek, difficulty breathing and severe trismus. He had a history of toothache one month prior to admission. Upon clinical examination, there was a diffuse swelling over the right mandible. Other examinations were unremarkable. Provisional diagnosis of a right para-pharyngeal abscess was made secondary to a possible infected right lower 3rd molar, with a differential diagnosis of a right parotid abscess with para-pharyngeal extension. Radiological assessment using computed tomography (CT) of the head and neck region showed an abscess over the right para-pharyngeal area, soft palate and right submandibular region. The narrowest part of the airway was at the region posterior to the soft palate, measuring approximately 1 cm. All staff and equipment were prepared for intubating a difficult airway. The patient was transferred to the control environment (operation theatre) for intubation. Awake nasal fibreoptic intubation (AFOI) was successfully performed for this patient using intravenous dexmedetomidine alone as the sedative.

DOI

10.21608/ejentas.2020.25104.1181

Keywords

Awake nasal fibreoptic intubation, Dexmedetomidine, Para-pharyngeal Abscess, Sedation

Authors

First Name

Abdul Jabar

Last Name

Ismail

MiddleName

-

Affiliation

Department of Anesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan.

Email

abduljabbarismail@gmail.com

City

-

Orcid

-

First Name

Wan Aireene

Last Name

Wan Ahmeed

MiddleName

-

Affiliation

Department of Radiology, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

Email

waireene@usm.my

City

-

Orcid

0000-0002-9976-1509

First Name

Rhendra Hardy

Last Name

Mohd Zaini

MiddleName

-

Affiliation

Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia

Email

rhendra@gmail.com

City

-

Orcid

-

First Name

Wan Fadzlina

Last Name

Wan Muhd Shukeri

MiddleName

-

Affiliation

Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia

Email

wfadzlina@usm.my

City

Kota Bharu

Orcid

-

First Name

Mohd Zulfakar

Last Name

Mazlan

MiddleName

-

Affiliation

Department of Anesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan.

Email

zulfakar@usm.my

City

-

Orcid

0000-0002-3452-1280

Volume

22

Article Issue

22

Related Issue

25028

Issue Date

2021-01-01

Receive Date

2020-03-03

Publish Date

2021-01-01

Page Start

1

Page End

5

Print ISSN

2090-0740

Online ISSN

2090-3405

Link

https://ejentas.journals.ekb.eg/article_129466.html

Detail API

https://ejentas.journals.ekb.eg/service?article_code=129466

Order

11

Type

Case report

Type Code

473

Publication Type

Journal

Publication Title

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

Publication Link

https://ejentas.journals.ekb.eg/

MainTitle

Awake Nasal Fiberoptic Intubation in Diffuse Para-pharyngeal Abscess

Details

Type

Article

Created At

22 Jan 2023