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一例罕见的可移动声带息肉导致动态气道阻塞的麻醉管理:病例报告

Anesthetic management of a rare case of mobile vocal cord polyp causing dynamic airway obstruction: A case report.

作者信息

Choudhary Jaya, Singh Ankita, Chakraborty Saikat

机构信息

Department of Anaesthesiology, Medica Superspecialty Hospital, Kolkata, West Bengal, India.

出版信息

Saudi J Anaesth. 2024 Oct-Dec;18(4):580-582. doi: 10.4103/sja.sja_229_24. Epub 2024 Oct 2.

Abstract

We report the anesthetic management of a patient presenting with a mobile vocal cord lesion in combination with restricted mouth opening. Fiber-optic laryngoscopy revealed a highly mobile vocal cord lesion, moving in and out of the vocal cords with respiration. A very small tracheal lumen was visible posteriorly during expiration. ASA difficult airway algorithm was applied, and the patient was successfully intubated awake with a # 5 microlaryngeal tube loaded over a pediatric bronchoscope. We aim to highlight the importance of detailed preoperative evaluation, adopting difficult airway algorithms and utilization of devices, with which we have maximum expertise with some modification as the key to avoid airway-related adverse events in such patients.

摘要

我们报告了一例伴有张口受限的可移动声带病变患者的麻醉管理情况。纤维喉镜检查发现声带病变活动度高,随呼吸在声带间进出。呼气时可见后方气管腔非常小。应用了美国麻醉医师协会(ASA)困难气道处理流程,患者通过在小儿支气管镜上套入5号微喉管成功实施清醒插管。我们旨在强调详细的术前评估、采用困难气道处理流程以及使用我们最擅长的设备并做一些改进的重要性,这是避免此类患者发生气道相关不良事件的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/892d/11587953/982fad002de0/SJA-18-580-g001.jpg

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