Oral and maxillofacial surgery and facial fractures: surgical airway in midface trauma: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral and maxillofacial surgery and facial fractures: surgical airway in midface trauma

Sample item

A patient with comminuted midface and mandibular fractures has heavy bleeding in the mouth. Oral intubation fails, bag-mask ventilation is inadequate and oxygen saturation is falling. What is the next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Cricothyroidotomy

When the airway cannot be secured by intubation or ventilated by mask in facial trauma, a surgical airway through the cricothyroid membrane is the life-saving step. Nasal routes are risky with midface fractures and may pass into the cranium.

Option by option

  • A. Insertion of a nasopharyngeal airway

    A nasopharyngeal airway is unsafe with midface fractures and will not rescue complete obstruction.

  • B. Blind nasotracheal intubation

    Blind nasotracheal intubation is hazardous with midface fractures and a possible skull base injury.

  • C. Cricothyroidotomy (correct)

    Correct. Cricothyroidotomy is the immediate rescue in a cannot intubate, cannot oxygenate situation.

  • D. Repeat laryngoscopy after a CT scan

    Delaying for a CT scan would allow fatal hypoxia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is C, Cricothyroidotomy. When the airway cannot be secured by intubation or ventilated by mask in facial trauma, a surgical airway through the cricothyroid membrane is the life-saving step.

Why is "Insertion of a nasopharyngeal airway" not the answer?

A nasopharyngeal airway is unsafe with midface fractures and will not rescue complete obstruction.

Why is "Blind nasotracheal intubation" not the answer?

Blind nasotracheal intubation is hazardous with midface fractures and a possible skull base injury.

Why is "Repeat laryngoscopy after a CT scan" not the answer?

Delaying for a CT scan would allow fatal hypoxia.

What concept does this question test?

It tests Oral and maxillofacial surgery and facial fractures: surgical airway in midface trauma in Dentistry. Nasal routes are risky with midface fractures and may pass into the cranium.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral and maxillofacial surgery and facial fractures: surgical airway in midface trauma?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.