Keimyung Med J.  2019 Dec;38(1,2):45-50. 10.0000/kmj.2019.38.1.45.

A Case Report of Emergency Cricothyroidotomy Due to Tracheal Intubation Failure in the Patient with Posterior Glottic Stenosis Due to Inhalation Burn

• Han I
• An MG
• Kang HJ
• Park ES
• Cho YW

• KMID: 2469577
• DOI: http://doi.org/10.0000/kmj.2019.38.1.45

Abstract

Injuries of the larynx are common in patients with a history of inhalation burns. When anesthesia is performed in such patients, the possibility of tracheal intubation should be thoroughly checked in advance, and preparation should be made in case of possible failure. 73-year-old woman who underwent laser cordotomy due to posterior glottic stenosis due to inhalation burn. Her height and weight were 140 cm and 58.9 kg. We proceeded anesthesia, because preoperative fiberoptic laryngoscopy and otolaryngology consultation showed that tracheal intubation was possible. However, the intubation failed and the manual ventilation was not performed afterwards, so the cricothyroidotomy was performed as an emergency. Anesthesia in patients with posterior glottic stenosis due to inhalation burns requires a great deal of attention and, above all, thorough evaluation in order to confirm the possibility of tracheal intubation. If this is not possible, you should look for alternatives and be prepared, and even if you think it's possible, try anesthesia with thorough preparation for the possible failure.

Keyword

Cricothyroidotomy; Inhalation burn; Intubation; Posterior glottic stenosis

MeSH Terms

Aged
Anesthesia
Burns, Inhalation*
Constriction, Pathologic*
Cordotomy
Emergencies*
Female
Humans
Inhalation*
Intubation*
Laryngoscopy
Larynx
Otolaryngology
Ventilation