Fuseya Satoshi, Ichino Takashi, Tanaka Satoshi, Ishida Kumiko, Ishida Takashi, Kawamata Mikito
Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto City, Nagano, 390-8621, Japan.
JA Clin Rep. 2018 Jun 5;4(1):43. doi: 10.1186/s40981-018-0180-3.
Laryngeal mask airway (LMA) insertion contributes to airway protection in patients with a laryngeal tumor around the glottis. There has been no report of LMA insertion itself exacerbating airway obstruction in such patients.
A 62-year-old male underwent elective surgical resection of a large laryngeal polyp. The polyp was attached to the right vocal fold and synchronously swung inward into the trachea and outward to the larynx with inspiration and expiration, respectively. Although manual positive pressure ventilation was easily achieved without any airway obstruction after anesthetic induction, the airway was completely obstructed by the polyp lodged between the vocal cords immediately after LMA insertion. Soon after removal of the LMA, patency of the airway was dramatically improved.
Our experience indicates that we should pay attention to airway obstruction due to lodging of the polyp between the vocal cords after LMA insertion in patients with a laryngeal polyp.
喉罩置入有助于声门周围喉肿瘤患者的气道保护。尚无喉罩置入本身会加重此类患者气道梗阻的报道。
一名62岁男性接受了大型喉息肉择期手术切除。息肉附着于右侧声带，分别在吸气和呼气时同步向内摆动至气管、向外摆动至喉部。尽管麻醉诱导后手动正压通气很容易实现且无气道梗阻，但喉罩置入后息肉立即卡在声带之间，气道完全梗阻。喉罩移除后不久，气道通畅情况显著改善。
我们的经验表明，对于喉息肉患者，喉罩置入后应注意息肉卡在声带间导致的气道梗阻。
