Jin Gayoung, Lee Sukyoung, Park Jungchan
Department of the Anesthesiology and Pain Medicine, Samsung Medical Center, Seoul, Korea.
Anesth Pain Med (Seoul). 2024 Jul;19(3):256-260. doi: 10.17085/apm.23151. Epub 2024 Jul 23.
Epiglottis abnormality is rare condition and can lead embarrassing intubation to anesthesiologists. Here, we reported a case of successful management in a patient with unexpected hidden vocal cords due to epiglottis adhesion to the posterior wall of the laryngeal cavity.
A 60-year-old female with no underlying disease was scheduled for general anesthesia to undergo a left-cochlear implant operation. After the induction procedure (including intravenous injection of rocuronium), an epiglottic adhesion to the posterior wall of the laryngeal cavity and invisible vocal cords were confirmed. Although the first trial of intubation failed, the patient's airway was successfully managed using a technique that combined a video-styletscope (Markstein Sichtec Medical Co., 5.0 mm ID) with a video-laryngoscope (Insighters ®, Cedrus Medical).
Anesthesiologists may unexpectedly encounter asymptomatic abnormal airways with unknown causes. In such a situation, it is essential to establish a strategy and to select appropriate device according to patient circumstances.
会厌异常是一种罕见病症，可能会给麻醉医生的气管插管操作带来困扰。在此，我们报告了一例因会厌与喉腔后壁粘连导致意外隐匿声带的患者的成功处理病例。
一名无基础疾病的60岁女性计划接受全身麻醉下的左人工耳蜗植入手术。诱导过程（包括静脉注射罗库溴铵）后，确认会厌与喉腔后壁粘连且声带不可见。尽管首次插管尝试失败，但通过将视频探条喉镜（Markstein Sichtec Medical Co.，内径5.0 mm）与视频喉镜（Insighters®，Cedrus Medical）相结合的技术，成功管理了患者的气道。
麻醉医生可能会意外遇到病因不明的无症状气道异常情况。在这种情况下，根据患者情况制定策略并选择合适的设备至关重要。
