Major Head and Neck Oncosurgery, Laryngectomy, and Laser Airway Management — WACS Viva & Clinical Scenarios (ENT & Ophthalmology)

Exam-style major head and neck oncosurgery, laryngectomy, and laser airway management viva scenarios with examiner probes and model answers for ANAESTHESIA…

Scenarios covered

• SCENARIO 1: A 62-year-old chronic heavy smoker (ASA III) with T4a glottic squamous cell carcinoma causing 70% laryngeal lumen obstruction is scheduled for total laryngectomy and bilateral selective neck dissection. Outline your complete perioperative airway and anaesthetic management plan.
• SCENARIO 2: A 55-year-old male undergoes a 10-hour resection of buccal mucosa carcinoma with fibular osteocutaneous free-flap reconstruction. Detail your intraoperative haemodynamic, fluid, and rheological management to guarantee microvascular graft survival.
• SCENARIO 3: A 48-year-old female is scheduled for CO2 laser excision of a vocal cord polyp. Formulate your intraoperative protocol to prevent and immediately manage an airway fire.
• SCENARIO 4: A 68-year-old male with previous neck irradiation (60 Gy) presents for salvage total laryngopharyngectomy. Describe the anaesthetic considerations regarding difficult intubation, carotid sinus hypersensitivity, and postoperative flap monitoring.