Chronic gastroesophageal reflux disease and its effect on laryngeal visualization and intubation: a case report

Gastroesophageal reflux disease (GERD) can have a profound effect upon visualization of the larynx. Changes at the cellular level can produce edema and subglottic stenosis thus causing airway difficulties of dire consequence if not recognized. Preoperative anesthesia evaluation of any patient presenting with a history of GERD should alert the anesthesia provider to the possibility of airway management problems. Subsequent steps should be taken to prepare the patient for potential difficult airway management. Preventative measures are desirable and support a better outcome, but in many instances such measures are deferred and anesthesia proceeds anyway; should this occur, immediate access to fiberoptic visualization and a difficult airway cart is imperative. Due to the increasing incidence of GERD in the general population, it is of utmost importance that it be considered during any airway assessment. This will enhance patient care and eliminate the element of surprise during this critical time.