Ji Sung-Mi
Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University Hospital, Cheonan, Korea.
J Dent Anesth Pain Med. 2015 Sep;15(3):153-156. doi: 10.17245/jdapm.2015.15.3.153. Epub 2015 Sep 30.
A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a 6 × 4 × 8.6 cm heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.
一名47岁男性被送往手术室治疗下颌骨牙源性囊肿。气道的初步评估被认为是正常的。然而，麻醉诱导后，由于声门严重变形，我们无法对患者进行插管。纤维支气管镜检查和视频喉镜检查均无效。采用逆行导丝技术插管成功。手术结束后，患者康复，无任何并发症。随后对患者颈部进行的磁共振成像显示，茎突前咽旁间隙有一个6×4×8.6 cm的不均匀T2高信号、T1等信号且强化良好的肿块。患者被安排切除该肿块。我们计划通过纤维支气管镜进行清醒插管。手术成功，患者康复且无并发症。麻醉诱导可降低气道肌肉张力并增加气道变形。因此，仔细的气道评估是必要的。
