Ear, Nose and Throat Emergencies and Anesthesia

Ear, nose and throat (ENT) emergency procedures demand significant anesthetic challenges. Variety of emergency conditions like deep neck space infections (Ludwig's angina, retropharyngeal, parapharyngeal abscess), acute onset of stridor, epiglottitis, laryngotracheobronchitis, inhaled foreign bodies, facial injuries, etc. are a challenge to both the surgeon and the anesthesiologist and communication and cooperation is vital. Priority in emergency is to clear and secure the airway and consider requirement of ‘shared airway’. Preferred anesthesia and airway technique include awake flexible fiberoptic (FOB) guided intubation in cooperative patients’ and an inhalational induction in uncooperative patient or tracheostomy. Anticipation, vigilance, readiness for difficult intubation, emergency tracheostomy and team work is essential while managing ENT emergency procedures.