Airway management of surgical patients with head and neck malignancies

Current principles and techniques of airway management of surgical patients with head and neck malignancies are discussed in this article, with emphasis placed on avoiding associated airway problems. Careful assessment of the airway and communication with the head and neck surgeon enable the anesthesiologist to select the best approach for securing the patient's airway before the operation begins. Effective responses in the event that an unexpectedly difficult airway develops and the patient cannot be intubated with rigid laryngoscopy are reviewed. After surgery, the timing of extubation of the trachea will depend on both the length of the operation and the degree of edema or distortion of the upper airway produced by surgery. Often, extubation can be more of a challenge than the original intubation and requires a joint decision by the anesthesia and surgical teams.