How Do You Protect Airways During Rhinoplasty?

Question

i am planning to have a rhinoplasty but i dont like general anasthesia i want to have it with local anasthesia but i am afraid of aspiration can you tell me how do you protect airways during rhinoplasty do you place anything behind of nose and does it fully protect from aspiration?

Kenneth Hughes, MD · Answer

The only way to truly protect an airway is to have a secure airway, which is only possible with general anesthesia.  If you are really worried about aspiration, then local and sedation is not the best alternative.  If you are doing straight local, then airway reflexes would be intact and there should not be a true risk for aspiration.  However, this may not be comfortable if any bony work is undertaken.  Kenneth Hughes, MD Los Angeles, CA

Stephen Weber MD, FACS · Answer

The airway is typically protected by minimizing bleeding and ensuring that any blood does not wind up in the airway. This is achieved with meticulous technique and using pledgets to absorb any bleeding. With deeper sedation, the airway  can be maintained with an oral airway or a breathing tube in the case of general anesthesia. No technique is foolproof so ensure that you undergo surgery in an accredited facility with a board certified and experienced Facial Plastic Surgeon working alongside an experienced anesthesiologist. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery

Andres Bustillo, MD, FACS · Answer

The rhinoplasty procedure can be performed with either general anesthesia or IV sedation. If using IV sedation, the surgeon usually places a small amount of packing in the back of the nose to prevent any blood or secretions to run down the back of the nose and into the airway.

James M. Ridgway, MD, FACS · Answer

Dear John,

The question you ask is a good one. When patients undergo entirely local procedure they are able to protect their airway. If they are under conscious sedation (twilight sleep) the will have a nasopharyngeal pack that will protect fluids from draining to the airway. If general anesthesia is performed, the tube or laryngeal mask protects the airway. Regardless, the airway is always protected.

Be healthy and be well,

James M. Ridgway, MD, FACS

William Portuese, MD · Answer

For patient safety it's always best to undergo rhinoplasty under general anesthesia. The airway is totally protected  by a laryngeal mask airway, or an endotracheal tube. Placing any packing in the back of the nose while patients are awake and sedated can only lead to aspiration of the packing and blood down into the trachea. It is best to have a board certified physician anesthesiologist present in a certified ambulatory surgery center setting for the best practices of patient's safety. Having rhinoplasty performed under local anesthesia is a bad idea

How Do You Protect Airways During Rhinoplasty?

Answers (9)

Answer: Rhinoplasty under local anesthesia

Answer: Rhinoplasty under local anesthesia

Answer: Airway protection for rhinoplasty

Answer: Airway protection for rhinoplasty

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Everything you need to know about Rhinoplasty

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How Do You Protect Airways During Rhinoplasty?

Answers (9)

Answer: Rhinoplasty under local anesthesia

Answer: Rhinoplasty under local anesthesia

Answer: Airway protection for rhinoplasty

Answer: Airway protection for rhinoplasty

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.