Controversies in Airway Management for Patients with Le Fort Fractures

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Supanadee Jianwittayakit
Pattharaporn Sombood
Patphorn Sompakdee
Chosigawan Maneechot
Phongthara Vichitvejpaisal


The clinical management of patients with Le Fort fractures requires close collaboration between surgical and anesthesia teams to provide individualized care. Careful consideration and decision-making are necessary for selecting the timing and technique for airway intervention, as well as for managing complications and contingency planning. Critical factors include preoperative assessment, airway access and securing techniques, intraoperative ventilation, and postoperative care. However, there is ongoing debate regarding the timing of tracheostomy in patients with Le Fort fractures: whether it should be performed pre-operatively or post-intubation. While some anesthesiologists suggest early tracheostomy before surgery as a potential option, its use remains controversial due to the surgeon’s preference for post-intubation intervention, as it may increase the risk of complications in this patient population. Future research is needed to advance the field of airway management in this patient population, including advanced medical imaging and predictive models, novel airway management techniques, and patient-reported outcomes. By implementing these clinical considerations and advancing research, we can improve patient care and outcomes in this complex and challenging patient population.

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Review articles


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