Posted by vauron on February 13, 2010 at 21:22:11:In Reply to: mma surgery posted by eastTN on January 31, 2010 at 04:19:17:
(The following is pure guesswork based on nothing
but reading the web online so take it with a very
big grain of salt.)The article at
http://www.anesthesia-
analgesia.org/cgi/reprint/103/5/1267.pdf
reports a case where the patient "developed total
airway obstruction" after removing the tubes at
the end of an MMA operation. It sounds from the
article as though the problem is pretty rare and
moreover can be dealt with when it occurs before
discharge from the hospital.The crucial question is whether there is any risk
that the swelling could increase after discharge.
It's hard to imagine a responsible hospital
discharging you if that were a possibility.However for complete peace of mind, and then only
as a first aid measure when more qualified help is
delayed, you could look up the Wikipedia articles
on oropharyngeal airway and nasopharyngeal airway.
An airway of this sort is a tube you push down
your throat via respectively your mouth or one
nostril. It should reach down to about level with
your earlobe.Something about the dimensions of a drinking straw
should do, but more flexible and a fair bit
stiffer so that it doesn't collapse when inserted.If you can tolerate the likely gagging reflex, the
former (insertion via mouth) is simpler, but if
not then the latter (insertion through a nostril)
works even though it might seem gross to have a
tube running through your nasal passages.The trumpet-shaped end for the latter is only
necessary if you are uncomfortable going around
with a long length of tube sticking out of your
nose, and serves only to prevent the tube
disappearing into your nose, which can be a bit
awkward to retrieve. A practical alternative to
the trumpet flare is to tie a knot in the tube but
not so tight as to block the air flow---you can do
this when you're ready to cut off the bulk of
what's sticking out in case you decide to keep it
in for any length of time.Sometimes the inside end of the tube gets plugged
up with tissue. The easiest fix when you're the
one in control of positioning the tube is to pull
back on it until you can breathe easily. A more
robust solution, especially if you plan on being
unconscious while your buddy does this procedure,
is to drill a bunch of small holes near the end,
small enough that the end doesn't collapse, but
with total area about twice that of the cross-
section of the tube itself. The chances that your
throat tissue will block all these holes including
the end of the tube are pretty slim. The holes
can go as far up the tube as you want because the
tube is functioning purely as a stent, whence
leaks in it at any point are immaterial as long as
the holes don't compromise its strength and allow
it to collapse under pressure of your throat
tissues.