alexa Proboscis Nose (Giant Rhinophyma): Challenges to Facema
ISSN: 2155-6148

Journal of Anesthesia & Clinical Research
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Case Report

Proboscis Nose (Giant Rhinophyma): Challenges to Facemask Fit and Bag Ventilation

Sandhu HS1, Tripathi M1*, Agarwal A1, and Tripathi N2

1Department of Anaesthesiology, All India Institute of Medical Sciences-RISH, Rishikesh, India

2Internist, KGMU, Lucknow, India

*Corresponding Author:
Mukesh Tripathi
Professor and Head
Department of Anaesthesiology
All India Institute of Medial Sciences
Virbhadra, Rishikesh, Uttarakhand, India
Tel: 00919917119333
E-mail: [email protected]

Received date: June 14, 2016; Accepted date: July 26, 2016; Published date: August 02, 2016

Citation: Sandhu HS, Tripathi M, Agarwal A, Tripathi N (2016) Proboscis Nose (Giant Rhinophyma): Challenges to Facemask Fit and Bag Ventilation. J Anesth Clin Res 7:655. doi:10.4172/2155-6148.1000655

Copyright: © 2016 Sandhu HS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Rhinophyma is painless benign swelling due to hypertrophy of the sebaceous gland of the face and nose in particular. In a neglected case, it presented as ‘Proboscis-nose’. As it was hanging in front of nose it was compromising breathing ability of the patient during sleep. It was posing difficulty in placing normal size anstomical face-mask. We placed naso-pharyngeal airway under local anesthesia to retain nasal patency and largest size facemask (size-5) in a manner that it’s air filled cushion was kept deflated and wide mandibular arch was placed nasally to encase the swelling inside mask and then cushion was inflated to make it air tight fit on face. This helped us to get airtight fitting of the anatomical face mask and through nasopharyngeal airway allowed ventilation of the lungs during induction of general anesthesia before intubation. Rest of management and orotracheal intubation was achieved uneventful. We suggest use of nasal and oropharyngeal air way use and reverse uses of large facemask to attain bag-mask ventilation during induction of anesthesia in such cases.

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