Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Masters of Surgery Video Presentations

Pediatric Otolaryngology

Session: Masters of Surgery: Rhinology and Skull Base

Controlling the Chaos: Exit to Tracheostomy

Sunday, September 29, 2024
8:00 AM – 8:07 AM EDT
Location: MBCC, 222
Disclosure(s):
Autefeh S. Sajjadi, MD, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ethan C. Bassett, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: This video demonstrates ex-utero intrapartum (EXIT) procedure performed for a 30-week-old infant with fetal MRI findings concerning for congenital high airway obstruction syndrome (CHAOS). After delivery of the head and shoulders by our maternal fetal medicine (MFM) colleagues, pediatric anesthesiologists administered general anesthesia and we proceeded with Direct Laryngoscopy. Although there was a grade 1 view, we quickly found that there was soft tissue obstruction at the level of the glottis/subglottis where neither the suction nor bronchoscope could be passed to cannulate into the airway. The decision was made to proceed with tracheostomy. Unfortunately, the smallest tracheostomy tube in the hospital had a length of 30mm and was sitting on the carina when assessed with flexible tracheoscopy, the tracheostomy tube was then trimmed to an appropriate length, and the patient was then subsequently delivered by our MFM colleagues and transported to the NICU stabilization bed for full resuscitation. Although an EXIT is a rare procedure typically occurring at Academic centers; this video case demonstrates key considerations for any Otolaryngologist including the value of communication in multi-disciplinary care, the role of a brief for coordinating surgical steps, the importance of multiple airway plans prior to beginning and the ability to troubleshoot when instruments are not the optimum size/shape.

    Lead Presenter(s)

  • Autefeh S. Sajjadi, MD, MS

    Resident
    University of Minnesota Department of Otolaryngology
    Minneapolis, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Autefeh S. Sajjadi, MD, MS

    Resident
    University of Minnesota Department of Otolaryngology
    Minneapolis, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Presenter(s)

  • LJ

    Luke A. Jakubowski, MD

    Assistant Professor
    University of Minnesota Department of Otolaryngology
    Minneapolis, MN, United States

    Disclosure information not submitted.

  • LJ

    Luke A. Jakubowski, MD

    Assistant Professor
    University of Minnesota Department of Otolaryngology
    Minneapolis, MN, United States

    Disclosure information not submitted.

  • Ethan C. Bassett, MD

    Pediatric Otolaryngologist
    University of Minnesota Department of Otolaryngology
    Minneapolis, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Ethan C. Bassett, MD

    Pediatric Otolaryngologist
    University of Minnesota Department of Otolaryngology
    Minneapolis, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • BL

    Brentley Lindsey, MD

    Children's Minnesota Department of ENT and Facial Plastics, United States

    Disclosure information not submitted.

  • BL

    Brentley Lindsey, MD

    Children's Minnesota Department of ENT and Facial Plastics, United States

    Disclosure information not submitted.