Facial Injuries

Maxillofacial injuries affect theairway in many ways. Knowing the factors which may lead to airway management other than Macintosh laryngoscopy will help emergency medical team in decision making and thus avoid any fatal situation. The present retrospective observational study was aimed to evaluate fractures and airway management patterns in cranio-maxillofacial injury patients with fracture of the mandible. It was also aimed to assess the clinical findings which predict airway management by other than Macintosh laryngoscopy. Anaesthesia management record, critical care assessment record and surgical team notes were evaluated in all cranio-maxillofacial injury patients with mandible fracture who required anaesthesia, critical care and ENT specialty services. The duration of the study was between 2009-10 to 2013-14 and the collected data was evaluated by using INSTAT software.Fifty nine (64.13%) out of 92 cranio-maxillofacial injury patients (with at least one head and neck or facial bone fracture) presented with mandibular fracture. The mean age was 27.25 years with 94.8% male patients. Laryngoscopy was expected not to be helpful in 38.33% cases. Video laryngoscopy appeared to be better or preferred over Machintosh laryngoscopy. Awake fiberoptic intubation was done in 30%, elective tracheostomy in 6.67% and retrograde intubation in 1.67% cases. Multiple facial bone fractures and mouth opening < 2 cm was independently associated with airway management other than laryngoscopy (p < 0.0001). Airway management is deviating towards video laryngoscopy from Macintosh laryngoscopy. Awake Fiberoptic intubation still plays a big role. Submental and blind intubations are becoming less prevalent.