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from Section 3 - Passing the Gas
Published online by Cambridge University Press: 09 June 2025
Both anaesthesia for maxillofacial and ENT surgery may require ‘sharing’ the airway with the surgeon, or at least having limited access to the airway and a number of airway devices are available to ensure the patient has a patent and secure airway at all times.
A number of areas need to be considered. Many patients are children, there is a risk of airway contamination with blood, bone teeth etc. In particular, perioperatively, it is easy to underestimate blood loss blood can be swallowed. Another area is patients with head and neck cancers. These patients may not only have a number of comorbidities (heavy alcohol and/or nicotine use, cachexia and weight loss) but have very difficult airways to manage because of tumour involvement or radiotherapy.
Patients with significant airway problems (from infection, tumour, radiotherapy) may need awake fibreoptic tracheal intubation)
Middle ear surgery may also require induced hypotension and prophylaxis of postoperative nausea and vomiting.
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