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Postoperative Airway Maintenance

William K. Hamilton, MD; Willis Warner, MD
JAMA. 1966;198(1):73-74. doi:10.1001/jama.1966.03110140123033.
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A 12-year-old white boy was admitted to the hospital with a three weeks' history of recurrent epistaxis. Nasal obstruction on the right side had been noted for two to three years. A review of systems was otherwise noncontributory.

Abnormal findings on physical examination were confined to the right nasopharynx, where a 2 × 2cm polypoid mass was visualized. Laboratory findings included normal results of urinalysis; hemoglobin, 12.5 gm/100 ml; white blood cell count, 7,300, with a normal differential count. The preoperative diagnosis was nasopharyngeal angiofibroma.

The day following admission premedication with sodium pentobarbital (Nembutal) and scopolamine hydrobromide was given one hour prior to surgery. Induction with halothane, nitrous oxide, and oxygen was uneventful. The trachea was intubated with a cuffed endotracheal tube, and the nasopharyngeal fibroma was removed with a rongeur forceps. Bleeding was copious for a few minutes, but was controlled by a posterior nasal pack of lamb's wool.


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