Use of transnasal jet ventilation-assisted fiberoptic intubation in obstructive sleep apnea patients undergoing orthognathic surgery: a new technique.

摘要

Obstructive sleep apnea patients undergoing orthog-nathic surgery present a challenge to the anesthesiologist. These patients have a complex interplay of soft and hard tissues contributing to a difficult airway.1'2 Obstructive sleep apnea patients have been reported to have increased body mass index,3'4 hypotonicity of the hypopharynx leading to upper airway collapsibil-ity,5 and large tongue and redundant soft palate that can obstruct the airway.6 Obstructive sleep apnea patients can also have abnormalities in the skeletal craniofacial structures,710 such as retrusive maxillo-mandibular complex and retrogenial and steep man-dibular plane. The combination of these soft and hard tissue abnormalities make intubation via direct laryngoscope difficult.