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Facial Artery Pseudoaneurysm: Challenges of Airway Management.

Abstract

A patient with recent jaw reconstruction presented for treatment of postoperative oropharyngeal hemorrhage. Asleep nasal fiberoptic intubation was attempted, but a rare and unanticipated complication ensued: rupture of right facial artery pseudoaneurysm. The difficult airway algorithm was followed up to the point of surgical airway. While nasal or oral fiberoptic intubation is often perceived as the safest approach for management of a difficult airway, we discuss alternative treatment strategies for patients with a facial pseudoaneurysm. Such alternatives include preoperative angiographic endovascular embolization of the vessel(s) feeding the pseudoaneurysm, and/or elective tracheostomy.

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  • Authors+Show Affiliations

    ,

    Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida.

    ,

    Department of Anesthesiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida.

    Oral and Maxillofacial Surgery, University of Miami Miller School of Medicine, Miami, Florida; Uniformed Services University of the Health Sciences, Bethesa, Maryland; Naval Medical Center Portsmouth, Portsmouth, Virginia.

    Source

    Anesthesia progress 65:1 pg 52-55

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29509524

    Citation

    TY - JOUR T1 - Facial Artery Pseudoaneurysm: Challenges of Airway Management. AU - Dudaryk,Roman, AU - Horn,Danielle B, AU - Green,J Marshall,3rd PY - 2018/09/01/pmc-release PY - 2018/3/7/entrez PY - 2018/3/7/pubmed PY - 2018/3/7/medline KW - Airway management KW - Case report KW - Difficult airway KW - Emergent tracheostomy KW - Facial pseudoaneurysm KW - Nasotracheal fiberoptic intubation KW - Oropharyngeal hemorrhage SP - 52 EP - 55 JF - Anesthesia progress JO - Anesth Prog VL - 65 IS - 1 N2 - A patient with recent jaw reconstruction presented for treatment of postoperative oropharyngeal hemorrhage. Asleep nasal fiberoptic intubation was attempted, but a rare and unanticipated complication ensued: rupture of right facial artery pseudoaneurysm. The difficult airway algorithm was followed up to the point of surgical airway. While nasal or oral fiberoptic intubation is often perceived as the safest approach for management of a difficult airway, we discuss alternative treatment strategies for patients with a facial pseudoaneurysm. Such alternatives include preoperative angiographic endovascular embolization of the vessel(s) feeding the pseudoaneurysm, and/or elective tracheostomy. SN - 1878-7177 UR - https://www.unboundmedicine.com/medline/citation/29509524/Facial_Artery_Pseudoaneurysm:_Challenges_of_Airway_Management. L2 - http://www.anesthesiaprogress.org/doi/10.2344/anpr-65-02-09?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed ER -