Panendoscopy and difficult airway – alternative ways of airway management in HNSCC patients including high-flow oxygenation

The patient with head and neck cancer (HNSCC) often presents unique challenges in airway management and anesthesiologic-surgical coordination and communication. Here, the advancement of noninvasive ventilation techniques such as JET ventilation and high-flow oxygenation open up new possibilities to ensure sufficient ventilation of the patient and to minimize the risk of tracheostomy to secure the airway. Different risk constellations during diagnostic panendoscopy are presented with evaluation of possible alternative ventilation options, taking into account the available literature as well as our own data on high-flow oxygenation. Data from a prospective study of 92 patients with malignant and benign lesions of the larynx and pharynx are shown, in whom airway management was performed by high-flow oxygenation during short surgical diagnostic and therapeutic procedures, including 14 patients with malignant and premalignant lesions. No relevant complications occurred in these cases, and the prerequisites for successful application are discussed on the basis of epidemilogical and anesthesiological parameters. In conclusion, high-flow oxygenation is another safe way for airway management in HNSCC, which can be a useful addition to the existing ventilation methods.

Publikationsverlauf

Artikel online veröffentlicht:
12. Mai 2023