Related Experiment Videos
[Unexpected difficult intubation caused by a laryngeal web]
Y Nakamura1, N Kurasako, T Iwaki
1Department of Anesthesiology, Okayama Rosai Hospital, Okayama 702-8055.
Masui. the Japanese Journal of Anesthesiology
|February 24, 2001
Summary
A laryngeal web caused unexpected difficult intubation in an adult during surgery. This rare condition required tracheostomy but was successfully treated, resolving airway obstruction.
Area of Science:
- Anesthesiology
- Otolaryngology
- Airway Management
Background:
- A 43-year-old woman underwent abdominal hysterectomy for uterine myoma.
- Standard laryngoscopy revealed clear vocal cords, suggesting no immediate airway obstruction.
Observation:
- Multiple attempts to intubate with a 6.5 mm tracheal tube failed due to resistance below the vocal cords.
- A laryngeal mask airway was used for anesthesia during the procedure.
Findings:
- Postoperatively, the patient experienced dyspnea.
- Bronchoscopy identified a laryngeal web causing significant airway narrowing below the vocal cords.
- Emergency tracheostomy was performed to secure the airway.
Implications:
- Laryngeal webs are a rare but critical cause of difficult intubation.
- Prompt diagnosis and airway management, including tracheostomy, are vital for patient outcomes.
- Successful treatment and decannulation were achieved, with no long-term sequelae.