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Difficult tracheal intubation and post-extubation airway stenosis in an 11-month-old patient with unrecognized

Natsuko Ohsima1, Fumimasa Amaya1, Shunsuke Yamakita1

  • 11Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kajii-cho 465 Kamigyo-Ku, Kyoto, 604-0096 Japan.

JA Clinical Reports
|March 2, 2018
PubMed

Insights

Unrecognized subglottic stenosis in an infant caused difficult tracheal intubation and airway issues. Early diagnosis is crucial for managing pediatric airway complications and ensuring patient safety during anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Otolaryngology
  • Medical Case Reports

Background:

  • Subglottic stenosis presents a significant risk for difficult tracheal intubation in pediatric patients.
  • Undiagnosed subglottic stenosis can lead to severe airway complications during general anesthesia.
  • This case highlights the potential for unrecognized subglottic stenosis in infants.

Purpose of the Study:

  • To report a case of difficult tracheal intubation due to unrecognized subglottic stenosis in an infant.
  • To emphasize the importance of considering subglottic stenosis in pediatric airway management.
  • To discuss the management and outcomes of such cases.

Main Methods:

  • A case presentation of an 11-month-old female undergoing elective surgery.
  • Description of anesthetic induction and intubation challenges encountered.
  • Details of the successful intubation strategy and postoperative management.

Main Results:

  • Multiple attempts with cuffed endotracheal tubes failed due to an advanced subglottic lesion.
  • Successful intubation was achieved with a smaller, uncuffed endotracheal tube.
  • The patient experienced post-extubation stridor and respiratory distress, requiring dexamethasone treatment.

Conclusions:

  • Unrecognized subglottic stenosis is a critical factor in difficult pediatric tracheal intubation.
  • Prompt recognition and appropriate airway management are essential to prevent adverse outcomes.
  • This case underscores the need for thorough preoperative airway assessment in infants.
Abstract

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