Matsumoto K
Department of Anesthesia, Kariwa-gun General Hospital, Kashiwazaki 945-8535.
Masui. 2001 Jul;50(7):786-8.
Huge laryngeal cyst is rare, but may cause difficulty or inability in tracheal intubation during induction of general anesthesia. A 69-year-old patient was scheduled for laryngomicroscopic cystectomy. In this patient, we examined two methods of oro-tracheal intubation either with rigid laryngoscopy or flexible fiberscopy using transnasal fiberoptic monitoring. Direct laryngoscopy failed to expose the epiglottis because of large cyst being fragile and easy to bleed. And even oral fiberscopy intubation was also difficult since a large mass hindered acquiring a suitable view. However, trans-nasal fiberscopy monitoring could guide the oro-tracheal fiber into the trachea for intubation. When an anesthesiologist can predict the abnormality of epiglottis, this combination might be recommended for difficult airway and intubation. Postoperative respiratory management under intubating state was necessary because of bleeding, airway edema, and deviation of the larynx after tumor resection. We reported anesthetic management of a patient with epiglottis gigantic cyst occupying the laryngopharyngeal airway. It is a rare tumor leading to difficulty of induction of anesthesia and necessitating postoperative intubated respiratory care.
巨大喉囊肿较为罕见，但在全身麻醉诱导期间可能导致气管插管困难或无法插管。一名69岁患者计划接受喉显微囊肿切除术。在该患者中，我们检查了两种经口气管插管方法，即使用硬喉镜或通过经鼻纤维内镜监测的可弯曲纤维喉镜。由于巨大囊肿脆弱且容易出血，直接喉镜检查未能暴露会厌。而且由于巨大肿物妨碍获得合适视野，即使经口纤维喉镜插管也很困难。然而，经鼻纤维内镜监测可引导经口纤维气管镜进入气管进行插管。当麻醉医生能够预测会厌异常时，对于困难气道和插管，可能推荐这种联合方法。由于肿瘤切除后出血、气道水肿和喉部移位，术后在插管状态下进行呼吸管理是必要的。我们报告了一例会厌巨大囊肿占据喉咽气道患者的麻醉管理。这是一种罕见的肿瘤，导致麻醉诱导困难且术后需要插管呼吸护理。
