Radiation induced changes in the airway—anaesthetic implications

Abstract

SummaryRadiation induces a variety of changes in the airway that can potentially lead to difficult intubation. Osteoradionecrosis (ORN) of the mandible, a severe consequence of radiotherapy for head and neck malignancies can cause a reduction of the ‘mandibular space’ and alteration of the morphometric measurements, viz. thyromental distance, hyomandibular distance, anterior mandibular length and posterior mandibular length, that usually predict difficult intubation. A case of osteoradionecrosis of the mandible presenting for elective surgery under general anaesthesia is presented. The primary intention of this article is to focus awareness amongst anaesthesiologists on the myriad of airway problems to be anticipated in cancer patients who present for surgery after radiotherapy.