Korean J Anesthesiol.  2016 Aug;69(4):386-389. 10.4097/kjae.2016.69.4.386.

Difficult endotracheal intubation secondary to tracheal deviation and stenosis in a patient with severe kyphoscoliosis: a case report

• Kim HJ
• Choi YS
• Park SH
• Jo JH

• KMID: 2344606
• DOI: http://doi.org/10.4097/kjae.2016.69.4.386

Abstract

We report on a case of difficult endotracheal intubation in a patient with marked tracheal deviation at an angle of 90 degrees combined with stenosis due to kyphoscoliosis with vertebral body fusion. After induction of general anesthesia, a proper laryngeal view was easily obtained using a videolaryngoscope. But a tracheal tube could not be advanced more than 3 cm beyond the vocal cords due to resistance, despite various attempts, including the use of small size tubes, full rotation of the tube tip, and fiberoptic bronchoscopy. Ultimately, the airway was successfully secured by placing a tube tip above the area of resistance and by additionally packing saline-soaked gauzes around the tracheal inlet to minimize gas leakage and to fasten the tube in the trachea.

Keyword

Intubation; Kyphosis; Scoliosis; Tracheal disease

MeSH Terms

Anesthesia, General
Bays
Bronchoscopy
Constriction, Pathologic*
Humans
Intubation
Intubation, Intratracheal*
Kyphosis
Scoliosis
Trachea
Tracheal Diseases
Vocal Cords