Maxillofacial trauma patient: coping with the difficult airway
Open accessAbstract
Establishing a secure airway in a trauma patient is one of the primary essentials of treatment. Any flaw in airway management may lead to grave morbidity and mortality. Maxillofacial trauma presents a complex problem with regard to the patient's airway. By definition, the injury compromises the patient's airway and it is, therefore, must be protected. In most cases, the patient undergoes surgery for maxillofacial trauma or for other, more severe, life-threatening injuries, and securing the airway is the first step in the introduction of general anaesthesia. In such patients, we anticipate difficult endotracheal intubation and, often, also difficult mask ventilation. In addition, the patient is usually regarded as having a "full stomach" and has not been cleared of a C-spine injury, which may complicate airway management furthermore. The time available to accomplish the task is short and the patient's condition may deteriorate rapidly. Both decision-making and performance are impaired in such circumstances. In this review, we discuss the complexity of the situation and present a treatment approach.
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Patients with mandibular fractures in 2 or more locations may be easier to intubate due to increased mobility of the mandible and attached soft tissues.
“Although patients with mandibular fractures in 2 or more locations may be easier to intubate due to increased mobility of the mandible and attached soft tissues”
From Airway Management in Trauma (2018) · cites this paper as [66]
In “Maxillofacial Trauma and Airway Injuries” (page unavailable), the paper says a bilateral anterior mandibular fracture may displace the tongue backward and block the airway. “The Complexity of the situation” describes maxillofacial trauma as often making intubation difficult. The paper does not describe increased mandibular mobility as making these patients easier to intubate. (LLM, conf=0.78)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredAssociated condylar fractures may cause a mechanical obstruction limiting mouth opening, making laryngoscopy and intubation difficult.
“associated condylar fractures may cause a mechanical obstruction limiting mouth opening, making laryngoscopy and intubation difficult.64,66”
From Airway Management in Trauma (2018) · cites this paper as [66]
In “Approach to the Maxillofacial Trauma Patient’s Airway Management” (page not provided), the paper says temporomandibular joint injury can limit mouth opening and complicate airway management. It does not specifically identify condylar fractures or describe a mechanical obstruction caused by them. (LLM, conf=0.86)
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Research works printed but not linked: 31
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Sorted by citations
Kovacs, G., & Sowers, N. (2018) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2017.08.006 · Cited by 115 · see citing works
- Authors
- Krausz, A. A., el-Naaj, I. A., & Barak, M.
- Affiliations
- Rambam Health Care Campus (IL)
- Venue
- World Journal of Emergency Surgery
- Published
- 2009-05-27
- Volume
- 4
- Issue
- 1
- Pages
- 21-21
- ISSN
- 1749-7922 (ISSN-L)
- PMC
- PMC2693512
- OpenAlex
- W2134455713
- Cited by
- 44
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 5 · 2017: 7 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 3 · 2012: 4
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- World Journal of Emergency Surgery (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Facial Trauma and Fracture Management
- Keywords
- maxillofacial trauma, difficult airway, airway management, difficult intubation, difficult mask ventilation, general anesthesia, full stomach, trauma surgery, emergency airway management
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