頁籤選單縮合
題名 | Difficult Fiber-optic Intubation in a Patient with Giant Neck Masses: The Role of McCoy Laryngoscope in Elevating Compressed Laryngeal Aperture |
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作者 | Yeh, Lijen; Chen, Hung-shu; Tan, Ping-heng; Liu, Ping-hsin; Hsieh, Shao-wei; Hung, Kuo-chuan; | 書刊名 | Acta Anaesthesiologica Taiwanica |
卷期 | 51:4 2013.12[民102.12] |
頁次 | 頁180-183 |
分類號 | 410.025 |
關鍵詞 | Fiber optic technology; Intubation; Intratracheal; Difficult; Laryngoscopes; McCoy; Neck; Mass; |
語文 | 英文(English) |
英文摘要 | Airway management in patients with giant neck masses is usually a challenge to anesthesiologists. A giant neck mass could compress the airway and thus impede endotracheal intubation. We encountered a situation where the giant neck masses of a patient pushed the epiglottis posteriorly toward the posterior pharyngeal wall and compressed the laryngeal aperture narrowing after anesthetic induction, causing direct laryngoscopic intubation and sequential fiber-optic intubation failed. The neck masses twisted the aryepiglottic fold tortuously and clogged the laryngeal aperture tightly, making a flexible fiber-optic bronchoscope unable to pass through the laryngeal aperture. Later, we utilized a McCoy laryngoscope alternately to lift the compressed larynx up and away from the posterior pharyngeal wall, creating a passage and completing endotracheal intubation successfully with the aid of a gum elastic bougie. Our case suggested that the tilting tip blade of the McCoy laryngoscope could lever the tongue base up against the tumor mass compression to improve laryngeal views and facilitate endotracheal intubation when a difficult fiber-optic intubation was encountered on a compressed laryngeal aperture. |
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