J Dent Anesth Pain Med.  2015 Dec;15(4):235-239.

Combitube insertion in the situation of acute airway obstruction after extubation in patients underwent two-jaw surgery

• Choi YJ
• Park S
• Chi SI
• Kim HJ
• Seo KS

Abstract

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

Keyword

Airway obstruction; Combitube; Extubation; Post-anesthesia complication, Two-jaw surgery

MeSH Terms

Airway Obstruction*
Edema
Emergencies
Hematoma
Humans
Laryngeal Masks
Mouth
Oxygen
Young Adult
Oxygen

Figure

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  Fig. 1 The Combitube kit (37 Fr, Mallinckrodt, USA).

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  Fig. 2 Patient intubated with a Combitube.

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  Fig. 3 Facial computer tomography (CT) scan. (a) Previous CT (b) Postoperative CT.

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