Da Broi U, Zauli M, Bonfreschi V, Cason L, Parodi P C, Osti M, Pasetto A, Riberti C
Cattedra di Anestesia e Rianimazione, Università degli Studi, Udine.
Minerva Anestesiol. 1996 Oct;62(10):333-7.
Authors report a Launoise-Bensaude-Madelung disease case, in a 64 year old man, admitted to a Plastic Surgical Department for obesity, dysphonia, dysphagia, dyspnea. Early symptoms appeared 20 years before Hospital admission. Lipomatous tissue occupied nape, mandible, neck and shoulders. Surgical exeresis of lipomatous tissue under general anesthesia needed for the patient. Neck movements and mouth opening were short (Mallampati Score = 4); a neck computed tomography showed a tracheal compression and right displacement. Tracheal intubation was considered difficult or impossible. Nose-tracheal intubation was performed using a pediatric fiberoptic instrument as guide for a small gauge tracheal tube. Tracheal stenosis required many attempts for correct nose-tracheal intubation. Fiberoptic instrument as guide for tracheal tube can be useful for patients with Launoise-Bensaude-Madelung disease, when tracheal intubation is considered difficult or impossible. Knowledge of fiberoptic tracheal intubation techniques is mandatory for anesthesiologists, allowing tracheal intubation in patients with anatomical variations of mouth or upper respiratory airways.
作者报告了一例劳诺瓦-本索德-马德隆病病例，患者为一名64岁男性，因肥胖、声音嘶哑、吞咽困难、呼吸困难入住整形外科。早期症状出现在入院前20年。脂肪组织占据了颈背、下颌、颈部和肩部。患者需要在全身麻醉下进行脂肪组织的手术切除。颈部活动和张口受限（马兰帕蒂评分=4）；颈部计算机断层扫描显示气管受压并向右移位。气管插管被认为困难或无法进行。使用小儿纤维光学器械作为小口径气管导管的引导进行鼻气管插管。气管狭窄导致多次尝试才成功进行鼻气管插管。当气管插管被认为困难或无法进行时，纤维光学器械作为气管导管的引导对劳诺瓦-本索德-马德隆病患者可能有用。麻醉医生必须掌握纤维光学气管插管技术，以便对口腔或上呼吸道存在解剖变异的患者进行气管插管。
