Chen Yi-Ting, Ho Chun-Ning, Hung Kuo-Chuan
Department of Anesthesiology, E-DA Hospital, Kaohsiung, Taiwan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Tzu Chi Med J. 2017 Jul-Sep;29(3):174-176. doi: 10.4103/tcmj.tcmj_63_17.
A retropharyngeal mass may distort the airway anatomy and reduce the space available for manipulation of intubation devices. We encountered a patient with a cervical chordoma occupying the retropharyngeal space. Fiber-optic orotracheal intubation was attempted to secure the airway. Although the fiber-optic bronchoscope (FOB) was successfully placed into the trachea, the tracheal tube could not be passed through the glottis. An airway was then successfully established with the Trachway device, a video-assisted system with a rigid but malleable intubating stylet. In conclusion, although a FOB is commonly used to secure a difficult airway, the present case report demonstrates that fiber-optic intubation is not always successful. Video intubation devices with a rigid stylet (such as Trachway) may be helpful in patients with a cervical chordoma. We suggest this device be available as backup for patients with distorted airway anatomy.
咽后肿物可能会使气道解剖结构变形，并减少用于操作插管设备的可用空间。我们遇到一名患有占据咽后间隙的颈椎脊索瘤的患者。尝试进行纤维光导经口气管插管以确保气道安全。尽管纤维光导支气管镜（FOB）成功置入气管，但气管导管无法通过声门。随后使用Trachway设备成功建立了气道，这是一种带有刚性但可塑形插管探条的视频辅助系统。总之，尽管FOB常用于确保困难气道的安全，但本病例报告表明纤维光导插管并不总是成功的。带有刚性探条的视频插管设备（如Trachway）可能对患有颈椎脊索瘤的患者有帮助。我们建议将该设备作为气道解剖结构变形患者的备用设备。
