RİNOPLASTİ NEDENİYLE RETROMOLAR ENTÜBASYON YAPILAN HASTADA BİLATERAL SAGİTTAL SPLİT RAMUS OSTEOTOMİSİ

Bu vaka raporunda; bilateral sagittal split ramus osteo- tomisi planlanan hastada, geçirmiş olduğu rinoplasti ameliyatları nedeniyle retromolar entübasyonla yapılan ortognatik cerrahinin sunumu amaçlanmıştır. Mandibular deformitesi olan 22 yaşındaki bayan hasta Ağız Diş ve Çene Cerrahisi kliniğine başvurdu. Hastada bilateral sagittal split ramus osteotomisi yapılarak alt çenenin 6 mm geri alınması planlandı. Genel anestezi öncesinde rutin hazırlıklarında hastanın 3 ay önce rinoplasti yaptırdığı öğrenildi. Rinoplasti işlemi sonrası elde edilen estetik görünümün bozulmaması için nazal entübasyondan vazgeçildi. Ameliyat sırasında oklüzyon kontrollerini etkilemeyecek şekilde retromolar entübas- yon yapılarak hasta başarılı bir şekilde opere edildi. Hava yolu güvenliğini sağlamada sıklıkla kullanılan oral ve nazal entübasyon her zaman uygulanamayabilir. Retromolar bölgede yeterli boşluk varsa retromolar entübasyon tekniği ortognatik cerrahi ameliyatlarında alternatif bir yöntem olarak düşünülebilir. Anahtar Kelimeler: entübasyon, ortognatik cerrahi, retromola  RETROMOLAR INTUBATION IN A PATIENT WITH RHINOPLASTY UNDERGOING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMYABSTRACTIn this case report, we aimed to present retromolar intubation in a patient undergoing bilateral sagittal split ramus osteotomy. Nasal entubation was impossible for this patient with rhinoplasty.A-22-year old female with mandibular deformity was referred to the Department of Oral and Maxillofacial Surgery. Orthognathic surgery was planned as a first surgery concept according to patient’s individual and orthodontist request. Bilateral sagittal split osteotomy was planned for mandibular setback. Patient has been operated for rhinoplasty by her plastic surgeon three months ago. Because of adverse effects and risks of damage to rhinoplasty, nasotracheal intubation was contraindicated. Retromolar intubation was preferred. This tecnique allowed intraoperative assessment ofthe occlusion and maxillomandibular fixation during the operation.Sometimes orotracheal and nasotracheal intubation are contraindicated. In the presence of enough space in the retromolar region, retromolar intubation techniques in orthognathic surgery can be considered as an alternative method of operation. Key Words: intubation, orthognathic surgery, retromolar
Anahtar Kelimeler:

entübasyon, ortognatik cerrahi

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