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Case Reports
. 2016 Nov;10(11):ZD19-ZD20.
doi: 10.7860/JCDR/2016/22408.8863. Epub 2016 Nov 1.

Prosthodontic Approach in Management of Prolonged Neonatal Intubation

Vikas B Kamble  1 , Shital K Shah  2 , Vishnu B Rathod  3 , Priyanka S Ambadkar  4 , Charudutt N Patil  4
Affiliations
Case Reports

Prosthodontic Approach in Management of Prolonged Neonatal Intubation

Vikas B Kamble et al. J Clin Diagn Res. 2016 Nov.

Abstract

Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa. Ineffective stabilization of the tubes is a frequent problem often resulting in accidental extubation and displacement of orotracheal and orogastric tube. Hence, these tubes must be stabilized against displacement from tongue and jaw movements to prevent discomfort and subsequent tissue trauma. Complications of prolonged endotracheal intubation include palatal groove formation by pressure against the hard palate, infection, accidental extubation, malposition, laryngeal or tracheal edema and ulceration, tracheal stenosis, vocal cord injury. Various oral appliances are used for infants to stabilize the tubes and prevent complications associated with long term intubation. This case report describes a prosthodontic approach in management of prolonged neonatal intubation.

Keywords: Endotracheal intubation; Neonate; Orogastric Intubation; Prolonged intubation.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Pre-operative extra oral view.
[Table/Fig-2]:
[Table/Fig-2]:
Polysiloxane putty impression made with spoon like acrylic tray.
[Table/Fig-3]:
[Table/Fig-3]:
Primary cast.
[Table/Fig-4]:
[Table/Fig-4]:
Polysiloxane putty impression made with acrylic impression tray.
[Table/Fig-5]:
[Table/Fig-5]:
Master cast.
[Table/Fig-6]:
[Table/Fig-6]:
Appliance fabricated.
[Table/Fig-7]:
[Table/Fig-7]:
Appliance secured with orotracheal and orogastric tube.
[Table/Fig-8]:
[Table/Fig-8]:
Respiration supported by oro-tracheal intubation and feeding performed by oro-gastric tube.
See this image and copyright information in PMC

References

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