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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
PLUNGING RANULA: DIFFICULT AIRWAY AND ANAESTHETIC MANAGEMENT
Author
Neha Chandrakar*, C. P. Bhagat, K.K. Sahare, Neha Bhagwat
Email
nehachandrakargmc@gmail.com
keyword
Ranula, Fiberoptic intubation, Difficult airway.
Abstract
A ranula is a type of mucus extravasation cyst (mucocele) found on the floor of the mouth and can extend into the submandibular, submental, retropharyngeal spaces, lateral aspect of the neck and upper mediastinum which may pose potential airway obstruction which leads to difficulty in airway management. A 28 year old female weighing 57 kg visited our hospital in the ENT department with a painless huge, tense swelling in the submental region with complains of dysphagia and discomfort due to the mass.. Mouth opening was three fingers and Mallampati grading was IV. Excision of ranula was planned under general anesthesia after awake fibreoptic nasal intubation as the first line of airway management, keeping tracheostomy standby. Mass was resected by cervical and oral approach and intraoperative course was uneventful. Patient was extubated fully awake and postoperatively she was hemodynamically stable. Airway management of patients with neck swelling is always challenging for the anesthetists. A strategy needs to be developed in order to anticipate & manage patients with difficult airway. This includes identifying the potential problems, considering different options selection of an appropriate plan in the particular scenario. The Flexible fiberoptic endoscope is the most valuable single tool available for the anaesthesiologist to manage the difficult airway.
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