RESUMO
INTRODUCTION: Nasotracheal intubation is the commonest method used to induce anaesthesia in oral surgery patients. It has a distinct advantage of providing good accessibility for oral surgical procedures. ANATOMY AND PROCEDURE: One must know the anatomy involved, the pathway and procedure of intubation, the pre-anaesthetic medication and complications which may be seen at the time of intubation. The surgeon must have the knowhow of the tube and the procedure which are explained in detail in the article. COMPLICATIONS: Several complications can arise while performing the procedure which may be operator induced or arising due to anatomical variations. CONCLUSION: It is prudent for the oral surgeon to know the basics of nasotracheal intubation in order to form a useful team member for management of complications arising from anaesthesia. Recent years have seen improvement in the armamentarium. These help negate the blindness of the procedure.
RESUMO
SUMMARY: This case report is of a rare occurrence of necrotic ulcerative changes in a female patient with Fanconi's anaemia and its successful periodontal management. BACKGROUND: The response of the periodontium to certain genetic and haematological disorders may vary from bleeding, ulcerations and necrosis to a more severe form of periodontitis. Periodontal management in such conditions still remains an enigma with respect to the timing of the periodontal intervention with regard to the systemic wellbeing of the patient. METHODS: Necrotising ulcerative lesions in a patient with Fanconi's anaemia (FA) progressed rapidly in a week's time necessitating early preliminary periodontal care, which included scaling and root planning using ultrasonic equipment supplemented with hydrogen peroxide irrigation, in conjunction with systemic antibiotics and blood transfusion. RESULTS: Following 1 unit (500ml) of fresh whole blood transfusion 24 hours preoperatively, basic periodontal therapy, comprising of removal of necrotic slough and thorough scaling was done. There was marked resolution of the necrotic ulceration and related symptoms when the patient was followed up for a period of 1 month. CONCLUSION: This report reconfirms most oral manifestations of Fanconi's anaemia and is the first of its kind to associate necrotic ulcerative changes of the gingiva with FA. It also goes a step further to emphasise the clinical significance of multidisciplinary approach towards successful patient management, which was the primary objective.
