Open AccessFeatures of adequate intubating security in patients with odontogenic and tonsilogenic neck phlegmons
Author(s) -
V. O. Shaprynskyi,
Volodymyr Kryvetskyi,
V. G. Suleimanova,
B.O. Mitiuk,
V.Iu. Dombrovskyi
Publication year - 2018
Publication title -
vìsnik vìnnicʹkogo nacìonalʹnogo medičnogo unìversitetu
Language(s) - English
Resource type - Journals
eISSN - 2522-9354
pISSN - 1817-7883
DOI - 10.31393/reports-vnmedical-2018-22(3)-27
Subject(s) - medicine , mediastinitis , intubation , odontogenic , surgery , nasotracheal intubation , odontogenic infection , tracheotomy , bronchoscopy , tracheal intubation , anesthesia , pathology
Recently, a tracheostomy was considered the method of choice for provide ventilating of patients with deep neck phlegmons, but current trends recognize that tracheal intubation with bronchoscope is the most rational way of adequate breathing security in such patients. Objective - to investigate the peculiarities of features of adequate intu bating security in patients with odontogenic and tonsilogenic neck phlegmons. 70 patients with deep neck phlegmons of odontogenic 4(7 (67%)) and tonsilogenic origin - (23 (33%)) have been investigated. 47 (67%) suffered from descending mediastinitis. Tracheal intubation was performed using orotracheal laryngoscope, bronchoscope or through tracheostomy. 33 (47.1%) patients underwent orotra cheal intubation with a bronchoscope, 34 (48.6%) with a laryngoscope, and only in three cases (4.3%) tracheostomy was used. Bronchoscopic intubation was performed in 57.4% of patients with odontogenic phlegmons, and only in 26.1% cases of oropharyngeal spaces suppuration. The percentage of tracheostomies was the same in two groups of patients and showed 4.3%. Mortality rate was 12.9%. Thus, 57.4% of patients with odontogenic neck phlegmons need for bronchoscopic tracheal intubation, a tracheostomy is used extremely rarely (4.3%). Intubation with laryngoscope is possible in 70% of patients with tonsilogenic suppuration. Comparison of tracheal intubation in patients with deep neck phlegmons with and without descending mediastinitis is prospects for further research.