Deep Neck Space Infections, Ludwig's Angina, and Complex Maxillofacial Airway Pathologies — WACS Viva & Clinical Scenarios (ENT & Ophthalmology)

Exam-style deep neck space infections, ludwig's angina, and complex maxillofacial airway pathologies viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 38-year-old man (ASA IV E) presents with a 5-day history of odontogenic pain, woody brawny induration of the submandibular region, elevated and protruding tongue, severe trismus (inter-incisor gap 0.5 cm), and stridor. Detail your anaesthetic assessment and airway securing strategy for surgical decompression.
• SCENARIO 2: A 24-year-old female (ASA III E) with a massive unilateral parapharyngeal abscess causing medial displacement of the pharyngeal wall and uvular deviation is scheduled for urgent drainage. Detail your steps to secure the airway without precipitating purulent rupture and aspiration.
• SCENARIO 3: A 45-year-old male with deep neck space infection develops sudden tachycardia (HR 140 bpm), BP 75/40 mmHg, chest pain, and widening of the superior mediastinum on portable chest X-ray. Formulate your resuscitation and intraoperative management for cervical mediastinotomy.
• SCENARIO 4: A 29-year-old male involved in an assault presents with bilateral pan-facial fractures, intraoral bleeding, expanding sublingual haematoma, and progressively worsening dyspnoea. Outline your decision algorithm between awake oral/nasal intubation, cricothyroidotomy, and emergency awake tracheostomy.