# Optimizing Airway Management Strategies for Anterior Neck Hematoma Following Parotidectomy

## TL;DR

This case report describes a successful airway management strategy for a patient who developed a dangerous neck hematoma after parotidectomy surgery.

## Contribution

The paper presents a novel approach to managing difficult airways in post-parotidectomy anterior neck hematomas.

## Key findings

- Maintaining spontaneous ventilation and using a video laryngoscope with a D-blade helped manage the airway safely.
- Surgical incision of the hematoma and careful anesthetic titration were key to successful intervention.
- Collaboration between surgical and anesthesia teams is essential for positive outcomes in such cases.

## Abstract

There is minimal research on the true incidence of postoperative neck hematomas following parotidectomy. Managing difficult airways in patients with an anterior neck hematoma requires extreme caution due to the high risk of complete airway collapse. In this case report, a 79-year-old male diagnosed with parotid squamous cell carcinoma underwent a parotidectomy and subsequently developed an anterior neck hematoma as a postoperative complication. Airway management was achieved by maintaining spontaneous ventilation and carefully titrating intravenous and inhaled anesthetics, followed by surgical incision of the hematoma. The use of a video laryngoscope with a D-blade and the initial avoidance of neuromuscular blockade facilitated safe airway control. This case highlights the critical need for prompt intervention in post-parotidectomy neck hematomas and underscores the importance of coordinated efforts between surgical and anesthesia teams. Additionally, strict adherence to established airway management protocols and the application of varied techniques are vital for ensuring positive patient outcomes.