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05:05
A Structured Approach to Extubation in Mechanically Ventilated Rats
Published on: July 18, 2025
[Relapsing polychondritis: a possible cause of difficult extubation]
A Guillon1, S Hottier, J Fusciardi
1Service d'anesthésie-réanimation, CHR d'Orléans, 14, avenue de l'Hôpital, 45100 Orléans, France. Antoineguillon78@yahoo.fr
Annales Francaises D'Anesthesie Et De Reanimation
|August 8, 2006
Summary
Relapsing polychondritis can cause airway collapse during extubation, necessitating a tracheostomy. Anesthesiologists must recognize this rare condition and assess airway risks preoperatively.
Area of Science:
- Anesthesiology
- Immunology
- Otorhinolaryngology
Background:
- Relapsing polychondritis (RP) is a rare systemic autoimmune disease characterized by progressive cartilage destruction.
- Airway involvement, particularly the upper airway, poses significant anesthetic challenges in patients with RP.
Observation:
- A 54-year-old woman with suspected relapsing polychondritis experienced upper airway inspiratory collapse and ventilatory distress upon extubation after nasal septum biopsy.
- Tracheal intubation was successful, but extubation failure mandated emergent tracheostomy placement.
Findings:
- Histopathological examination of the nasal cartilage biopsy confirmed severe relapsing polychondritis.
- The case highlights the critical risk of airway collapse due to RP-induced cartilaginous structural changes.
Implications:
- Anesthesiologists must be vigilant for relapsing polychondritis, especially when airway compromise is suspected.
- Preanesthetic evaluation should meticulously assess for anatomical and histological modifications of upper airway cartilaginous structures in patients with suspected RP.
- Early recognition and preparedness for airway emergencies are crucial for managing patients with relapsing polychondritis.
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