Objective: To explore the perioperative airway management for transoral surgical lysis in patients with irreducible atlantoaxial dislocation and posterior atlantoaxial or occipitocervical fixation.
Methods: Thirty patients undergoing surgical lysis through transoral approach with oral endotracheal intubation (OEI group) between September 2009 and June 2010 were recruited. And another 31 patients underwent transoral surgical lysis from December 2008 to August 2009 with percutaneous dilatational tracheostomy (PDT group). The time interval from artificial airway establishment to start of operation, the duration of nasogastric feeding, the incidence of respiratory complications and the postoperative length of hospital stay were compared between two groups.
Results: The time interval from artificial airway establishment to the start of operation in the OEI group was significantly shorter than that in the PDT group [(39 ± 15) vs (58 ± 16) min, P < 0.01]. The duration for nasogastric feeding in the OEI group was significantly shorter than that in the PDT group [(6.0 ± 1.2) vs (7.9 ± 0.3) days, P < 0.01]. And the postoperative length of hospital stay was also shorter in the OEI group than that in the PDT group [(9.5 ± 1.7) vs (11.8 ± 3.4) days, P < 0.01].
Conclusion: The management of perioperative airway with oral endotracheal intubation may avoid the complications of PDT, improve the utilizing efficiency of operating rooms and shorten the postoperative length of hospital stay.