España Fuente L, de la Rica Fernández P, González González J L
Servicio de Anestesiología y Reanimación, Hospital San Agustín, Avilés, Asturias, España.
Servicio de Anestesiología y Reanimación, Hospital San Agustín, Avilés, Asturias, España.
Rev Esp Anestesiol Reanim. 2017 Feb;64(2):108-111. doi: 10.1016/j.redar.2016.08.003. Epub 2016 Sep 28.
Laryngeal cysts are largely asymptomatic and typically described in the context of incidental discovery on routine laryngoscopy. These cysts, in adults are even rarer and can have catastrophic consequences in an anaesthetized patient if airway management is inappropriate. We describe a case of difficult endotracheal intubation and the treatment of an adult patient with an asymptomatic, giant vallecular cyst that was discovered during rapid-sequence induction of general anesthesia in urgent surgery. In conclusion, vallecular cysts can cause extreme problems in securing the airway. It is important to avoid complications associated with repeated attempts at intubation, airway loss, or cyst rupture causing difficulty visualizing vocal cords and aspiration. The use of King Vision videolaryngoscope is a good alternative in these cases. Close attention to logistics and the immediate availability of an otolaryngologist is vital.
喉囊肿大多无症状,通常是在常规喉镜检查时偶然发现的。这些囊肿在成人中更为罕见,如果气道管理不当,在麻醉患者中可能会产生灾难性后果。我们描述了一例困难气管插管病例以及一名成年患者的治疗情况,该患者在急诊手术快速诱导全身麻醉期间发现了一个无症状的巨大会厌囊肿。总之,会厌囊肿在确保气道安全方面可能会导致极其严重的问题。避免与反复插管尝试、气道丢失或囊肿破裂导致声带可视化困难及误吸相关的并发症非常重要。在这些情况下,使用可视喉镜是一个很好的选择。密切关注后勤保障以及耳鼻喉科医生的随时可及至关重要。