Does the Number of Attempts of Endotracheal Intubation Influence the Incidence of Post-Extubation Dysphagia in Patients Undergoing Maxillofacial Surgical Procedures? - A Prospective Analysis

Aim: To evaluate the incidence and association of post-extubation dysphagia (PED) with varying number of attempts of endotracheal intubation in patients undergoing maxillofacial surgical procedures. Settings: One of the unnoticed complications of endotracheal intubation, yet with tragic consequences is post-extubation dysphagia. In a post maxillofacial surgical patient, this is masked by the extensiveness of the surgery and the immobilization protocols and hence need to be attended with utmost care. Materials and Methods: A two-year prospective analysis of patients undergoing maxillofacial surgical procedures for varied cause was done. Data regarding age, gender, medical history, indication for surgery, pre-anaesthetic evaluation, intraoperative records related to the number of intubation attempts and any complications associated and a water swallow test to test for PED 24 hours after surgery were recorded and subjected to statistical analysis. Results: Mean age of the population was 35.1 years and was predominantly male. About 62.5% of them were intubated by fiberoptic intubation, 35% by naso-endotracheal and 5% by oro-endotracheal intubation.65% of them were intubated more than once and a maximum of 7 attempts was done to secure the airway. 19 patients had PED and it was significantly associated with the number of attempts of intubation with p<0.001. Conclusion: PED is the tip of the iceberg and could indicate a serious underlying complication that could result in fatal complications if neglected and thus alarms the surgeon to watch out closely and address accordingly