Wu Sheng-Hua, Chen Kuang-I, Lu I-Chen, Huang Shu-Hung, Chu Kuong-Shing
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2007 Jun;23(6):309-12. doi: 10.1016/S1607-551X(09)70414-0.
Failure or difficulty in intubating the trachea can be either due to inability to visualize the glottis or some pathology at the level of or below the cords. This report describes a case of difficult intubation suspected of being related to neck scarring from previous surgery. Computed tomography (CT) was used to evaluate the patient's airway and revealed upper tracheal angulation. We describe a method to secure the airway in this patient with a two-person technique by rotating an oral endotracheal tube 180 degrees counterclockwise to adjust to the curvature of the trachea. Problems with intubation should be anticipated in patients with scarring of the neck, and equipment for aiding intubation should be on hand. Furthermore, we found that CT contributed to the assessment of the difficulty of intubation in this kind of patient.
气管插管失败或困难可能是由于无法看到声门或声带水平及以下存在某些病变。本报告描述了一例疑似与既往手术导致的颈部瘢痕有关的困难插管病例。计算机断层扫描（CT）用于评估患者气道，显示气管上段成角。我们描述了一种双人技术为该患者确保气道安全的方法，即将口腔气管导管逆时针旋转180度以适应气管的曲度。对于颈部有瘢痕的患者，应预见到插管问题，并应准备好辅助插管设备。此外，我们发现CT有助于评估这类患者的插管难度。
