Georgiopoulos Miltiadis, Papadakos Dimitrios, Kraniotis Pantelis, Lygeros Spyridon, Margaritis Vasilios, Karnabatidis Dimitrios, Gatzounis Georgios
Department of Neurosurgery, University Hospital of Patras, Patras, Achaia, Greece.
Department of Radiology, University Hospital of Patras, Patras, Achaia, Greece.
Surg Neurol Int. 2020 Dec 22;11:459. doi: 10.25259/SNI_808_2020. eCollection 2020.
We present a case and reviewed the literature regarding airway obstruction and angioedema after an anterior cervical discectomy and fusion (ACDF).
A 60-year-old female with degenerative cervical myelopathy and a previously undiagnosed epiglottic cyst underwent a C5-C6 ACDF; notably, the anesthesiologist found an epiglottic cyst when the patient was first intubated. Two hours postoperatively, the patient acutely developed severe neck swelling with airway obstruction due to angioedema. She was immediately treated with hydrocortisone and required a tracheostomy. The edema decreased markedly in the next 12 h and by the 3 postoperative day it resolved. Three months later, she had no residual medical sequelae.
Patients with epiglottic cysts who need cervical spine surgery should either first have the cyst treated or should be closely monitored postoperatively.
我们报告了一例病例，并回顾了有关颈椎前路椎间盘切除融合术（ACDF）后气道梗阻和血管性水肿的文献。
一名60岁患有退行性颈椎病且此前未诊断出会厌囊肿的女性接受了C5 - C6节段的ACDF手术；值得注意的是，麻醉医生在患者首次插管时发现了会厌囊肿。术后两小时，患者因血管性水肿急性出现严重颈部肿胀并伴有气道梗阻。她立即接受了氢化可的松治疗，并需要进行气管切开术。水肿在接下来的12小时内明显减轻，术后第3天消退。三个月后，她没有残留的医学后遗症。
患有会厌囊肿且需要进行颈椎手术的患者，要么首先对囊肿进行治疗，要么术后应密切监测。
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