Utility of the Awake Video Laryngoscopy Assisted Fibreoptic Intubation Technique in Maxillofacial Gunshot Injury - A Case Report

RATIONALE: Maxillofacial gunshot injury leads to significant soft tissue and bone defects, which compromise airway patency, thus posing a challenge for the anaesthesiologist. The utility of the videolaryngoscopy-assisted fibreoptic intubation (VAFI) technique in maxillofacial gunshot injury has not yet been described in the literature. PATIENT CONCERNS: We report the case of a young male presenting with extensive maxillofacial wounds with fractures of the bilateral maxilla, mandible and floor of orbit secondary to self-inflicted gunshot injury. DIAGNOSIS: Major peri-operative concerns included anticipated difficult airway, control of potential haemorrhage and airway oedema. TREATMENT: A flexible fibreoptic bronchoscope used in combination with a video laryngoscope was used to successfully secure the airway. OUTCOME: He was extubated on the same day and discharged after two weeks. TAKE-AWAY LESSONS: The current case highlights the safe and effective use of the videolaryngoscopy-assisted fibreoptic intubation technique in maxillofacial gunshot injury.