**7. Conclusion**

• Patients who present with head and neck pathology are more likely to have difficult airways, are at increased risk of difficulties during airway management,

**149**

**Author details**

and Abhishek Menon1

in Qatar, Doha, Qatar

Corporation, Doha, Qatar

Muayad M. Radi Al-Khafaji1,2\*, Hossam Makki1,2, Hassan Haider2

\*Address all correspondence to: mradi@hamad.com

provided the original work is properly cited.

1 Department of Otolaryngology - Head and Neck Surgery, Hamad Medical

2 Clinical Otolaryngology - Head and Neck Surgery, Weill Cornell Medical College

© 2021 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

, Furat Abbas1,2

*Airway Management in Head and Neck Pathology DOI: http://dx.doi.org/10.5772/intechopen.94498*

difficulties arise.

traumatic.

complications [20].

successful management.

tion may not be guaranteed.

and they are also more likely to require an emergency surgical airway when

• Proper Preoperative assessment and Multidisciplinary planning is required for

• Virtual endoscopy can be used to supplement conventional airway endoscopy

• Awake intubation is preferred in difficult airway cases where typical intuba-

• OSA patients are becoming increasingly identified in the surgical population, therefore appropriate measures are needed in order to treat patients at the

• Obesity and obstructive sleep apnea increase the risk for anesthetic and sedative complications, including post -operative cardiorespiratory

The lack of recognition of OSA cases pre-operatively poses significant challenges result from difficulties during airway management. To reduce encountered complication an appropriate anesthetic regimen including choice of medication, airway management and adequate postoperative monitoring should be optimized [24].

• Using the trans-nasal high-flow rapid insufflation ventilator exchange ("THRIVE") makes intubation and extubation less stressful and less

highest risk for OSA to reduce the perioperative complications.

to help in planning the management of difficult airway cases

*Special Considerations in Human Airway Management*

(REM) following surgery.

post -operative complication [19].

peri-operative complication risk.

• Extubate after the patient is completely awake

**adult OSA patients**

**6.6 In intra-operative care**

acting anesthetic drug.

with head position 30 degree.

• Consider use non-opioid anesthetic drug.

maintain their oxygen saturation on room air.

• Continue PAP therapy in case needed.

**6.7 In recovery room**

**6.8 In-ward management**

therapy.

5.Perioperative discontinuation of continuous positive airway pressure (CPAP)

6.Surgical stress and post-operative sedation may lead to disruption of sleep and apneic events at night affected by increased periods of rapid eye movement

**6.5 Highlights and pearls for upper airway mangament with elective surgery in** 

1.Focused history, physical examination and implementing screening tool in the (pre-operative care) are crucial in studying high risk OSA cases to reduce

2.In *mild OSA or low risk cases*, surgery can be proceeding with minimizing

• Prepare for difficult airway management, 25-degree head position, use short

• Consider invasive monitoring for respiratory & hemodynamic parameters.

• Close observation for oxygen saturation and hemodynamic for at least 2 hours,

• Close monitoring and continuous supplemental oxygen therapy until they can

• Patients who present with head and neck pathology are more likely to have difficult airways, are at increased risk of difficulties during airway management,

• Discharged patient should follow with sleep physician for re-assessment.

• Early use of positive airway pressure (PAP) in case of desaturation.

3.In *high risk and diagnosed OSA* cases should have the following [23]:

• Consider minimal sedation or regional anesthesia if appropriate

**148**

**7. Conclusion**

and they are also more likely to require an emergency surgical airway when difficulties arise.


The lack of recognition of OSA cases pre-operatively poses significant challenges result from difficulties during airway management. To reduce encountered complication an appropriate anesthetic regimen including choice of medication, airway management and adequate postoperative monitoring should be optimized [24].
