Uchiumi R, Itou K, Miyamoto M, Oda S, Taniguchi K, Honda N
Department of Anesthesiology, Oita Medical University.
Masui. 1993 Feb;42(2):292-5.
We experienced a case of difficult endotracheal intubation. The patient was a 43 year-old female with congenital oropharyngeal wall stenosis. She was suffering from fibromyoma of uterus and an operation was scheduled under general anesthesia. Her natural voice was nasal. She denied having any respiratory difficulty or difficulty in swallowing. Respiratory function test revealed a low peak flow but the other data were normal. Preceding endotracheal intubation, at laryngoscopy we noticed a stenosis of upper airway because of the web, extending from the middle pharynx to soft palate and its diameter was about 1 cm. Ordinary endotracheal intubation was impossible because of the stenosis. In this case, fortunately we succeeded fiberoptic endotracheal intubation under spontaneous respiration. We conclude that the examination of the pharynx is very important during the perioperative period.
我们遇到了一例困难气管插管病例。患者为一名43岁女性,患有先天性口咽壁狭窄。她患有子宫肌瘤,计划在全身麻醉下进行手术。她的自然嗓音呈鼻音。她否认有任何呼吸困难或吞咽困难。呼吸功能测试显示峰值流量较低,但其他数据正常。在进行气管插管前,喉镜检查时我们注意到由于咽蹼导致上气道狭窄,从咽中部延伸至软腭,其直径约为1厘米。由于狭窄,普通气管插管无法进行。在这种情况下,幸运的是我们在自主呼吸下成功进行了纤维支气管镜引导下气管插管。我们得出结论,围手术期对咽部的检查非常重要。