Chapter 8 - Anesthesia for ENT emergencies

Summary

This chapter provides a brief overview of otolaryngologic emergencies. Complete or partial airway obstruction is common in ENT practice and anesthesiologists are familiar with a variety of measures, such as tracheal intubation, to deal with this event. Intubation is often needed in cases of angioedema; this will usually be performed under topical anesthesia with the patient awake or lightly sedated. Airway-related bleeding may occur spontaneously, as with a bleeding tumor, as a consequence of anticoagulation (e.g. for atrial fibrillation), or following surgery (e.g. after UVPP surgery). Posterior epistaxis may be particularly severe, may be accompanied by hematemesis or melena, and may require general anesthesia and intubation as part of the treatment. Airway-related infections such as epiglottitis, retropharyngeal abscess and Ludwig's angina constitute an emergency airway. One approach commonly taken in such cases is awake intubation, especially in conjunction with a fiberscope.