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Unsuspected difficult intubation caused by a laryngeal web
1Chang Gung Memorial Hospital, Kaohsiung Medical Center, Department of Anesthesiology, Taiwan, ROC.
British Journal of Anaesthesia
|December 9, 1997
Summary
Difficult intubation in adults can be caused by an unsuspected laryngeal web. This case highlights a 0.5 cm anterior laryngeal web leading to subglottic stenosis and challenging tracheal tube insertion.
Area of Science:
- Anesthesiology
- Otolaryngology
- Medical Case Reports
Background:
- Difficult intubation poses significant risks during anesthesia.
- Laryngeal abnormalities are a rare but critical cause of airway obstruction.
- Early identification of airway anomalies is crucial for patient safety.
Observation:
- A case of unexpected difficult intubation in an adult patient is presented.
- Standard laryngoscopy revealed clear visualization of the posterior vocal cords.
- A 7.5-mm tracheal tube failed to pass the vocal cords due to resistance.
Findings:
- Multiple attempts with smaller tracheal tubes were unsuccessful.
- A 5.0-mm cuffed tracheal tube was ultimately passed.
- Microscopic examination by an otolaryngologist identified a 0.5 cm anterior laryngeal web causing subglottic stenosis.
Implications:
- Laryngeal webs should be considered in cases of unexplained difficult intubation.
- Accurate diagnosis requires specialized laryngeal examination.
- Prompt recognition and management of laryngeal webs are essential for preventing airway complications.