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Mask Ventilation in Edentulous and Bearded Patients

Rao, Vaidy, MD; Kosik, Edward, DO; Ganta, Raghuvender, MD; Windrix, Casey, MD

doi: 10.1213/ANE.0b013e318215d34c
Letters to the Editor: Letters & Announcements

Department of Anesthesiology University of Oklahoma Oklahoma City, Oklahoma (Rao, Kosik, Ganta, Windrix)

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To the Editor

Difficulty performing mask ventilation might be encountered in edentulous or bearded patients. For several years, we have utilized a method to circumvent this problem. After induction of anesthesia, an appropriately sized and lubricated nasal airway is inserted through the more patent nostril, and a suitably sized toddler mask used to ventilate the patient's lungs. As is shown in Figures 1 and 2, the mask extends from the bridge of the nose to the maxillary alveolar ridge. The mask is grasped in the conventional manner and, with the mouth held closed to prevent air from leaking during positive pressure, ventilation is totally accomplished through the nostrils.

Figure 1

Figure 1

Figure 2

Figure 2

We believe that our approach affords some advantage over that described by Racine et al.,1 wherein the caudal edge of the mask is placed above the lower lip and the neck is maintained in extension. Although ventilation occurs through both the nose and the mouth, 2 persons are required to both maintain a seal and manually ventilate the lungs.

Vaidy Rao, MD

Edward Kosik, DORaghuvender Ganta, MDCasey Windrix, MD Department of Anesthesiology

University of Oklahoma

Oklahoma City, Oklahoma

DISCLOSURES None of the authors reported any conflicts of interest and have abided by the IRB guidelines at their institution.

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1. Racine SX, Solis A, Hamou NA, Letoumelin P, Hepner DL, Beloucif S, Baillard C. Face mask ventilation in edentulous patients: a comparison of mandibular groove and lower lip placement. Anesthesiology 2010;112:1190–3
© 2011 International Anesthesia Research Society