Bales Travis, Hamid Abdulaziz, Fadumiye Christopher O
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
Medical College of Wisconsin, Milwaukee, WI, USA.
Int Med Case Rep J. 2024 Aug 6;17:739-744. doi: 10.2147/IMCRJ.S465848. eCollection 2024.
Radiation for head and neck cancer (HNC) can lead to neck fibrosis, commonly known as "woody neck", limiting neck mobility. We report the case of a 46-year-old male with a history of tonsillar squamous cell carcinoma, with a "woody neck" following multiple radiation treatments. Facial swelling and impending airway loss prompted emergent intubation. Despite nasotracheal tube placement, bilateral internal jugular vein occlusion led to a difficult tracheostomy. An airway exchange catheter (AEC) facilitated multiple attempts at tracheal cannulation, but due to challenging anatomy, prolonged nasotracheal intubation was maintained. Tracheostomy was attempted again with extracorporeal membrane oxygenation (ECMO) support, which resulted in successful tracheal cannulation.
头颈部癌症（HNC）放疗可导致颈部纤维化，俗称“木头颈”，限制颈部活动。我们报告一例46岁男性病例，有扁桃体鳞状细胞癌病史，在多次放疗后出现“木头颈”。面部肿胀及即将出现的气道阻塞促使紧急插管。尽管放置了鼻气管导管，但双侧颈内静脉闭塞导致气管造口术困难。气道交换导管（AEC）有助于多次尝试气管插管，但由于解剖结构复杂，仍维持了较长时间的鼻气管插管。在体外膜肺氧合（ECMO）支持下再次尝试气管造口术，最终成功进行了气管插管。
