Title: Acute Presentation of Partially Obstructing Laryngeal Tumour: A Case of Failed Awake Fibroptic Intubation
Authors: Dr Balasandhiya.P, Dr Gopinath.V, Dr Merlin Shalini Ruth
DOI: https://dx.doi.org/10.18535/jmscr/v8i9.36
Abstract
Assessing a difficult airway is one of the challenging problem in anaesthesia. Managing the laryngeal tumor depends on experience of anaesthesiologist, needs a careful preoperative evaluation and close cooperation with ENT surgeons are mandatory. Awake fiberoptic intubation is sometimes very challenging in patients with laryngeal carcinoma. We would like to present a case of 50-year-old male who attended emergency department with stridor and dyspnea taken up for emergency tracheostomy. He is a known case of possible laryngeal tumour. We would like to discuss the Anaesthetic management of this case.
References
- Toyota K, Uchida H, Ozasa H, Motooka A, Sakura S, Saito Y: Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis. Br J Anaesth 2004, 93:865–867.
- Pean D, Floch H, Beliard C, Piot B, Testa S, Bazin V, Lejus C, Asehnoune K: Propofol versus sevoflurane for fiberoptic intubation under breathing anesthesia in patients difficult to intubate. Minerva Anestesiol 2010, 76:780–786.
- Tsai CJ, Chu KS, Chen TI, Lu DV, Wang HM, Lu IC: A comparison of the effectiveness of dexmedetomidine versus propofol target-controlled infusion for sedation during fibreoptic nasotracheal intubation. Anaesthesia 2010, 65:254–259.
- Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, Hagberg CA, Caplan RA, Benumof JL, Berry FA, Blitt CD, Bode RH, Cheney FW, Connis RT, Guidry OF, Nickinovich DG, Ovassapian A, American Society of Anesthesiologists Task Force on Management of the Difficult Airway: Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2013, 118:251–270.
- Hsu HH, Ko WJ, Chen JS, Lin CH, Kuo SW, Huang SC, Lee YC: Extracorporeal membrane oxygenation in pulmonary crisis and primary graft dysfunction. J Heart Lung Transplant 2008, 27:233–237.
- Srivastava MC, Ramani GV, Garcia JP, Griffith BP, Uber PA, Park MH: Veno-venous extracorporeal membrane oxygenation bridging to pharmacotherapy in pulmonary arterial hypertensive crisis. J Heart Lung Transplant 2010, 29:811–813.
- Smith IJ, Sidebotham DA, Mc George AD, Dorman EB, Wilsher ML, Kolbe J:Use of extracorporeal membrane oxygenation during resection of tracheal papillomatosis. Anesthesiology 2009, 110:427–429.
- Park CS, Suh KW, Min JS. Cartilage-shaving procedure for the control of tracheal cartilage invasion by thyroid carcinoma. Head Neck 1993; 15:289e91.
- Hashmi NK, Mandel JE, Mirza N. Laryngeal mask airway in laryngoscopies: a safer alternative for the difficult airway. ORL J Otorhinolaryngol Relat Spec. 2009; 71:342–6.
- Ovassapian, S. J. Yelich, M. H. Dykes, and E. E. Brunner, “Fiberoptic nasotracheal intubation—incidence and causes of failure,” Anesthesia and Analgesia, vol. 62, no. 7, pp. 692–695, 1983.