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Airway Management of Orofacial Infections Originating in the Mandible
The primary aim of this study was to assess the incidence of a difficult airway and emergency tracheostomy in patients with orofacial infections originating in the mandible, and a secondary aim was to determine the potential predictors of difficult intubation. This retrospective single-center study...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304000/ https://www.ncbi.nlm.nih.gov/pubmed/37373939 http://dx.doi.org/10.3390/jpm13060950 |
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author | Sakkas, Andreas Weiß, Christel Zink, Wolfgang Rodriguez, Camila Alejandra Scheurer, Mario Pietzka, Sebastian Wilde, Frank Thiele, Oliver Christian Mischkowski, Robert Andreas Ebeling, Marcel |
author_facet | Sakkas, Andreas Weiß, Christel Zink, Wolfgang Rodriguez, Camila Alejandra Scheurer, Mario Pietzka, Sebastian Wilde, Frank Thiele, Oliver Christian Mischkowski, Robert Andreas Ebeling, Marcel |
author_sort | Sakkas, Andreas |
collection | PubMed |
description | The primary aim of this study was to assess the incidence of a difficult airway and emergency tracheostomy in patients with orofacial infections originating in the mandible, and a secondary aim was to determine the potential predictors of difficult intubation. This retrospective single-center study included all patients who were referred between 2015 and 2022 with an orofacial infection originating in the mandible and who were surgically drained under intubation anesthesia. The incidence of a difficult airway regarding ventilation, laryngoscopy, and intubation was analyzed descriptively. Associations between potential influencing factors and difficult intubation were examined via multivariable analysis. A total of 361 patients (mean age: 47.7 years) were included in the analysis. A difficult airway was present in 121/361 (33.5%) patients. Difficult intubation was most common in patients with infections of the massetericomandibular space (42.6%), followed by infections of the mouth floor (40%) and pterygomandibular space (23.5%). Dyspnea and stridor were not associated with the localization of infection (p = 0.6486/p = 0.4418). Multivariable analysis revealed increased age, restricted mouth opening, higher Mallampati scores, and higher Cormack–Lehane classification grades as significant predictors of difficult intubation. Higher BMI, dysphagia, dyspnea, stridor and a non-palpable mandibular rim did not influence the airway management. Patients with a difficult airway were more likely to be admitted to the ICU after surgery than patients with regular airway were (p = 0.0001). To conclude, the incidence of a difficult airway was high in patients with orofacial infections originating in the mandible. Older age, limited mouth opening, a higher Mallampati score, and a higher Cormack–Lehane grade were reliable predictors of difficult intubation. |
format | Online Article Text |
id | pubmed-10304000 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103040002023-06-29 Airway Management of Orofacial Infections Originating in the Mandible Sakkas, Andreas Weiß, Christel Zink, Wolfgang Rodriguez, Camila Alejandra Scheurer, Mario Pietzka, Sebastian Wilde, Frank Thiele, Oliver Christian Mischkowski, Robert Andreas Ebeling, Marcel J Pers Med Article The primary aim of this study was to assess the incidence of a difficult airway and emergency tracheostomy in patients with orofacial infections originating in the mandible, and a secondary aim was to determine the potential predictors of difficult intubation. This retrospective single-center study included all patients who were referred between 2015 and 2022 with an orofacial infection originating in the mandible and who were surgically drained under intubation anesthesia. The incidence of a difficult airway regarding ventilation, laryngoscopy, and intubation was analyzed descriptively. Associations between potential influencing factors and difficult intubation were examined via multivariable analysis. A total of 361 patients (mean age: 47.7 years) were included in the analysis. A difficult airway was present in 121/361 (33.5%) patients. Difficult intubation was most common in patients with infections of the massetericomandibular space (42.6%), followed by infections of the mouth floor (40%) and pterygomandibular space (23.5%). Dyspnea and stridor were not associated with the localization of infection (p = 0.6486/p = 0.4418). Multivariable analysis revealed increased age, restricted mouth opening, higher Mallampati scores, and higher Cormack–Lehane classification grades as significant predictors of difficult intubation. Higher BMI, dysphagia, dyspnea, stridor and a non-palpable mandibular rim did not influence the airway management. Patients with a difficult airway were more likely to be admitted to the ICU after surgery than patients with regular airway were (p = 0.0001). To conclude, the incidence of a difficult airway was high in patients with orofacial infections originating in the mandible. Older age, limited mouth opening, a higher Mallampati score, and a higher Cormack–Lehane grade were reliable predictors of difficult intubation. MDPI 2023-06-04 /pmc/articles/PMC10304000/ /pubmed/37373939 http://dx.doi.org/10.3390/jpm13060950 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sakkas, Andreas Weiß, Christel Zink, Wolfgang Rodriguez, Camila Alejandra Scheurer, Mario Pietzka, Sebastian Wilde, Frank Thiele, Oliver Christian Mischkowski, Robert Andreas Ebeling, Marcel Airway Management of Orofacial Infections Originating in the Mandible |
title | Airway Management of Orofacial Infections Originating in the Mandible |
title_full | Airway Management of Orofacial Infections Originating in the Mandible |
title_fullStr | Airway Management of Orofacial Infections Originating in the Mandible |
title_full_unstemmed | Airway Management of Orofacial Infections Originating in the Mandible |
title_short | Airway Management of Orofacial Infections Originating in the Mandible |
title_sort | airway management of orofacial infections originating in the mandible |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304000/ https://www.ncbi.nlm.nih.gov/pubmed/37373939 http://dx.doi.org/10.3390/jpm13060950 |
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