A serious anesthetic hazard during orthognathic surgery
Oral surgical procedures for the correction of maxillomandibular deformities present unique anesthetic problems, which, though reported in oral surgical journals, have not received sufficient attention in the anesthesiology literature. One of these unique problems relates to the fact that this type of surgery requires the extensive use of pneumatic saws and drills. The close proximity of the osteotomy sites to the airway, especially in maxillary surgery, presents the possibility that an endotracheal tube may be inadvertently damaged by the cutting instruments. The purpose of this paper is to apprise anesthesiologists of this potential hazard by presenting an unusual case in which both nasotracheal and pilot tubes were cut in the nasopharynx during maxillary segmental osteotomy.