Anesthetic Concerns in a Patient with Carcinoma Cheek with Absolute Trismus (Zero Mouth Opening) in a 60 Year Old Lady Posted for Wide Excision of Cheek with Hemi Mandibulectomy and Radical Neck Dissection with Myocutaneous Flap Cover

Dr A Rubia Sultana, Dr Murali Prabhakar, Dr Bhaskar

Abstract: Carcinoma cheek is a common malignancy in our country and is associated with tobacco, paan and gutka chewing. The patients are usually malnourished and anesthesiologist faces multiple problems before subjecting them to anesthesia, during the operating procedure and in the postoperative period. Trismus and inability to open the mouth is seen in many cases of carcinoma cheek and carries definitive risk in securing stable and adequate airway. The preoperative preparation, the intricacies involved in facilitating nasotracheal intubation and the measures needed to maintain an unobstructed airway in the postoperative period are discussed.

Keywords: Carcinoma cheek, trismus, blind nasal intubation, hemi mandibulectomy, myocutaneous flap cover, deltopectoral flap