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Background <p>Pre-oxygenation before anesthesia induction is vital, particularly in challenging intubation cases, to extend the apneic period. Nasal vascular malformations present unique airway management challenges due to bleeding risks during pre-oxygenation.</p> Methods <p>We developed and utilized a custom-made spacer device to facilitate pre-oxygenation in a patient with a large nasal vascular malformation. The spacer was designed to avoid direct pressure on the lesion while enabling a secure seal with a standard face mask. Pre-oxygenation was performed with the spacer in place, followed by uneventful oral intubation.</p> Results <p>The spacer allowed effective pre-oxygenation without causing trauma or bleeding from the vascular lesion. Oxygen saturation was maintained within optimal limits, and airway management proceeded smoothly.</p> Conclusion <p>This novel spacer-assisted technique provides a safe, cost-effective solution for pre-oxygenation in patients with facial vascular malformations, protruding tumors, or other challenging facial anatomies. It minimizes the risk of bleeding while ensuring effective oxygenation, thereby improving the safety of anesthesia induction.</p>

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Custom Spacer for Mask Ventilation in a Challenging Case of Nasal Vascular Malformation

  • 期刊论文

  • 发表日期：

    2025年7月9日

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  • Ragavi Alagarsamy,
  • Archana Sinha,
  • Meenakshi Mourya,
  • Rajpal Singh,
  • Rakesh Kain

摘要

Background

Pre-oxygenation before anesthesia induction is vital, particularly in challenging intubation cases, to extend the apneic period. Nasal vascular malformations present unique airway management challenges due to bleeding risks during pre-oxygenation.

Methods

We developed and utilized a custom-made spacer device to facilitate pre-oxygenation in a patient with a large nasal vascular malformation. The spacer was designed to avoid direct pressure on the lesion while enabling a secure seal with a standard face mask. Pre-oxygenation was performed with the spacer in place, followed by uneventful oral intubation.

Results

The spacer allowed effective pre-oxygenation without causing trauma or bleeding from the vascular lesion. Oxygen saturation was maintained within optimal limits, and airway management proceeded smoothly.

Conclusion

This novel spacer-assisted technique provides a safe, cost-effective solution for pre-oxygenation in patients with facial vascular malformations, protruding tumors, or other challenging facial anatomies. It minimizes the risk of bleeding while ensuring effective oxygenation, thereby improving the safety of anesthesia induction.