Eipe Naveen, Fossey Susan, Kingwell Stephen P
Department of Anesthesiology, The Ottawa Hospital, 1053 Carling Ave, Suite B310, Ottawa, K1Y 4E9, Ontario, Canada.
Indian J Anaesth. 2013 Nov;57(6):592-5. doi: 10.4103/0019-5049.123333.
We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways.
我们报告了一名患有长期强直性脊柱炎的患者的围手术期过程，该患者因会厌水平的巨大颈椎前纵韧带骨赘而出现严重吞咽困难。他计划接受颈椎前路减压手术，而手术入路可能排除了择期术前气管切开术。我们通过劈开的鼻咽气道进行了改良的清醒纤维鼻插管，同时通过插入另一侧鼻孔的改良鼻导管确保了充分的氧合。我们讨论了鼻插管的作用以及我们用于促进气管插管的两种改良鼻咽气道的使用。这种改良的鼻纤维插管技术可应用于其他颈椎异常患者和其他预期的困难气道。
