Anesth Pain Med.  2024 Apr;19(2):156-160. 10.17085/apm.23172.

Airway management of a patient with Mounier-Kuhn syndrome during general anesthesia - A case report -

• Cheon B
• Lee JH
• Kim JH
• Hwang SM

• KMID: 2555253
• DOI: http://doi.org/10.17085/apm.23172

Abstract

Background
Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by abnormal dilation of the trachea and main bronchi. MKS can be easily missed on chest X-rays, making diagnosis difficult. Under general anesthesia, challenges such as airway leakage or collapse during mechanical ventilation may prevent the achievement of adequate tidal volumes in patients with MKS. Case: A 94-year-old woman requiring emergency hemiarthroplasty of the hip under general anesthesia was admitted. Preoperative chest X-rays revealed dilation of the trachea and main bronchi, but the patient exhibited no respiratory symptoms. We diagnosed her with MKS and opted for an 8.0-mm-inner-diameter reinforced tracheal tube. We positioned the cuff in the subglottic area, inflating it while monitoring for air leakage. Throughout the surgery, we ensured that adequate air leak and tidal volume were maintained.
Conclusions
Anesthesiologists must conduct a comprehensive evaluation of patients with MKS, including a review of chest radiographs, and establish a meticulous anesthesia plan prior to surgery.

Keyword

Airway management; Chest X-ray; General anesthesia; Mounier-Kuhn syndrome; Trachea dilation; Tracheobronchomegaly

Figure

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  Fig. 1. Chest X-ray shows (A) the maximum transverse diameter of the trachea is 29.2 mm, (B) the shortest transverse diameter of trachea is 19.8 mm, (C) the diameter of the right main bronchus is 20.2 mm (D) the diameter of the left main bronchus is 15.3 mm.

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  Fig. 2. Postoperative chest X-ray (AP) shows right upper lobe infiltration.

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