Chapter 4 - The difficult airway in otolaryngology

Summary

This chapter deals with difficult airway management in the context of otolaryngologic surgery. To a large extent, the airway management technique for otolaryngologic surgery will depend on clinical circumstances as well as the airway management skills of the anesthesiologist and the available equipment. Should intubation be difficult, clinicians can still provide ventilation and oxygenation via face-mask ventilation. Most patients undergoing otolaryngologic surgery have their airway managed via tracheal intubation. Difficult airway management for otolaryngologic surgery relies heavily on the American Society of Anesthesiologists difficult airway algorithm and, particularly, on the use of awake intubation in the spontaneously breathing patient. The use of fiberoptic intubation for the airway management of patients undergoing otolaryngologic surgery is popular because this technique works well in the presence of many kinds of airway pathology. Many clinicians opt to perform this technique under topical anesthesia with the patient only lightly sedated.