Authors:
- Dr Hester Carter, Anaesthetic Registrar, University College London Hospital
- Dr Kirstie McPherson, Anaesthetic Consultant, University College London Hospital
Anaesthesia for ENT, oral/maxillofacial and dental surgery involves a wide range of procedures for patients of all ages with varied co-morbidities.
Our skill set demands strong teamwork, excellent communication, and technical proficiency. We will cover some of these areas in this article.
Teamwork
At University College London, specialist pre-assessment clinics involve anaesthetists, surgeons, perioperative physicians, speech and language therapists, and specialist nurses. Do you have anything similar in your hospital?
Our joint clinics allow for shared decision-making, risk counselling, and referral for non-surgical care in patients not suitable for high-risk surgery. Early discussions on awake-intubations, postoperative tracheostomy/laryngectomy, and the psychological impact of cosmetic changes prepare and support the patient for their perioperative journey. This multidisciplinary approach aids rapid optimisation of modifiable co-morbid disease and discussion of the risks of surgery and beyond.
Additionally, our weekly multidisciplinary ‘tracheostomy ward round’ provides regular assessment of patients with at-risk airways. During these rounds, the anaesthesia and ENT team work together to identify and monitor patients whose airways may deteriorate. Flexible nasendoscopy (FNE) helps guide airway-management decisions, ensuring patient safety and continuity of care. The Difficult Airway Society registry also tracks these patients, providing a national alert system and standardised patient information.