Prone positioning for head and neck reconstructive surgery

Division of Otolaryngology, Department of Surgery, University of Utah, 50 N. Medical Drive, 3C-120, Salt Lake City, Utah 84107, USA.
Head & Neck (Impact Factor: 2.64). 11/2007; 29(11):1041-5. DOI: 10.1002/hed.20650
Source: PubMed


Certain head and neck surgical cases require the patient to be positioned prone. Such positioning carries with it an attendant subset of risks and complications not otherwise encountered in more traditional supine positioning. Gaining awareness of these risks and complications, and developing proactive positioning strategies, will enable the surgical team to position the patient optimally for the procedure and provide for every consideration of patient safety.
This article consists of a specific literature review of those issues directly related to the anatomical and physiological concerns arising from prone positioning. Particular attention is paid to the cardiopulmonary, renal, ophthalmologic, and neurological vulnerabilities unique to this position.
Proper planning by the surgical team and utilization of the correct equipment are a necessity. A tailored approach to the needs of the individual patient and an intimate awareness of the potential pitfalls will contribute to better outcomes when using the prone position. © 2007 Wiley Periodicals, Inc. Head Neck, 2007

  • Source

    Preview · Article · Sep 2008 · The Open Anesthesiology Journal
  • [Show abstract] [Hide abstract]
    ABSTRACT: Literature review of complications unrelated directly to surgical skills involved in spinal deformity surgery. Highlight complications associated with perioperative issues. Complications can arise from mundane events that arise during the operative experience, but are not directly related to surgical skills. Literature reviews that touches on the more common potential complication events that do not involve direct surgical expertise. The topics of positioning, nutrition, blood loss, comorbidities, OR time, and pulmonary and GI concerns are discussed as basics that could derail a surgical outcome even with an otherwise uneventful surgical technique. The need for vigilance is stressed and the nuances of understanding these are discussed. Mundane events can derail a perfectly executed surgical undertaking. Attention to detail, team work, close monitoring, and checklist type focus will help to improve, focus, and avoid these preventable complications that have nothing to do with direct surgical skills.
    No preview · Article · Dec 2010 · Spine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Endotracheal tube displacement is one of the leading causes for airway related complications. Endotracheal tube displacement is much more common in the prone position than in the supine position. The study population consisted of 120 patients aged between 18-60 years, ASA class 1 and 2, undergoing surgery in the prone position who were randomly allocated into two groups of sixty patients each. The endotracheal tube was secured either with adhesive tape (Group A) or a Thomas tube holder (Group B). The ease of application and removal, effect on caliber of endotracheal tube, amount of displacement of endotracheal tube and also any injuries with either fixation method were studied. Both groups were comparable with respect to mean time taken for the application of the fixation device, peak airway pressure change after the application of the fixation device in the supine position and after positioning the patient in the prone position and the time taken for removal of the fixation device. Displacement was significantly larger in group A than in group B. Both methods of fixation of the endotracheal tube are clinically useful in the prone position but the Thomas tube holder is more effective than adhesive tape in preventing displacement of endotracheal tube.
    No preview · Article · Nov 2013 · Acta anaesthesiologica Belgica
Show more