Management of unanticipated difficult airway in a patient with well-visualized vocal cords using video laryngoscopy- A case report -
- Author:
Seunghee KI
1
;
Seung Bae CHO
;
Seongmin PARK
;
Jeonghan LEE
Author Information
- Publication Type:Case Report
- From:Anesthesia and Pain Medicine 2023;18(2):204-209
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Difficult airway occurs due to anatomical abnormalities of the airway that can be predicted through airway assessments; however, abnormalities beyond the vocal cord can be clinically asymptomatic and undetected until intubation failure to advance the endotracheal tube.Case: We present a case of an unanticipated difficult airway in a stuporous 80-year-old female with a recent history of intracerebral hemorrhage and prolonged intubation. She required emergency ventriculo-peritoneal shunt surgery due to the progression of her hydrocephalus. Under anesthesia, facemask ventilation was easy and video laryngoscopy provided a full view of the glottis; however, endotracheal tube (ETT) entry failed. We suspected stenosis beyond the vocal cord, and a smaller diameter ETT was inserted and maintained for airway management during emergency surgery. Postoperative neck computed tomography findings revealed laryngotracheal stenosis (LTS).
Conclusions:Anesthesiologists should be aware that LTS may be asymptomatic and consider difficult airway guidelines in patients with history of prolonged endotracheal intubation.
