• Title/Summary/Keyword: Difficult Intubation

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High Flow Nasal Cannula Assisted Tracheostomy for Securing Airways in Patients with Acute Respiratory Distress Induced by Glottic Cancer (급성 호흡곤란이 발생한 성문암 환자에서 기도 확보를 위한 고유량 비강 캐뉼라 보조 기관절개술)

  • Hong, Seung Woo;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.31-34
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    • 2020
  • Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.

Dyspnea after General Anesthesia in a Patient with Cerebral Palsy -A Case Report- (뇌성마비 환자에서 전신마취 후 나타난 호흡곤란 -증례보고-)

  • Min, Soo-Young;Lee, Jae-Ho;Kang, Jeong-Wan
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.55-60
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    • 2011
  • When patients with cerebral palsy are put under general anesthesia, there may be problems like difficult endotracheal intubation caused by deviation of respiratory tract due to scoliosis, hypotension related to chronic malnutrition and anemia, and failure of ventilation due to deformation of the thoracic cavity. The main clinical problem of postanesthetic complication is hypoxemia. The patients with cerebral palsy need close monitoring during treatment under general anesthesia and postanesthetic management. The purpose of this report is to evaluate a patient with cerebral palsy and mental retardation appeared to have dyspnea after general anesthesia.

A Case of Paratracheal Air Cyst Causing Dyspnea (호흡곤란을 유발한 기관주위 공기낭 1 예)

  • Han, Chang-Hee;Park, Sung-Ho;Choi, Kyung-Min;You, Ji-Hoon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.64-67
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    • 2009
  • Paratracheal air cysts are rare lesions and detected incidentally during CT scan or autopsy. Histopathologic diagnoses of paratracheal air cysts include trachocele, tracheal diverticulum and lymphoepithelial cyst. The cysts are lined by ciliated columnar epithelium and have communication with trachea. Previous reports suggested an association with obstructive lung disease because of increased expiratory pressures in these patients. Most of these cysts are asymptomatic but rarely cause productive cough, wheezing, recurrent laryngeal nerve paralysis and difficult intubation. We report a case of paratracheal air cyst causing dyspnea with a review of literature.

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A Rare Case of Tracheomalacia Associated with Vascular Ring in an Infant

  • Han Seok Joo;Sung Tae Yon;Lee Kyo Jun;Choi Hong Sik;Shim Yon Hee;Nam Yong Taek
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.63-67
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    • 2004
  • Tracheomalacia can be a life threatening upper air way obstructive disease in an infant and vascular rings can be also a major rare cause of tracheoesophageal obstruction. These two rare entities can be combined in one patient because the vascular ring can cause secondary tracheomalacia during development of fetus. The diagnosis of this combination and adequate surgical correction is occasionally difficult. This is a report of an infant who had not diagnosed tracheomalacia associated with vascular ring until 5 months of age because of the prolonged tracheal intubation. The rigid bronchoscopic examination performed under impression of tracheomalacia revealed a concentric tracheal collapse, an unusual bronchoscopic findings of tracheomalacia, which raised a suspicion of the tracheal compression by vascular rings. The 3-D reconstructive DT aortography clearly demonstrated the double aortic arch. The patient was treated surgically by simple division of the left aortic arch and aortopexy with good result. The vascular ring such as double aortic arch should be considered during the diagnosis of tracheomalacia in infants. If the tracheomalacia is associated with vascular ring, simultaneous surgical correction should be performed.

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Modified Tracheostomy for Severe Tracheal Stenosis (고도의 기관협착증에서 변형된 기관절개술의 적용)

  • Sa Young-Jo;Nam Sang-Yong;Wang Young-Pil;Park Jae-Kil
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.415-418
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    • 2006
  • When tracheal invasion of a malignant tumor or tracheal stenosis of a benign origin exists at the lower or anterior part of the trachea, tracheal intubation or conventional tracheostomy may be difficult, and in these cases a modified tracheostomy through the lower or lateral part of the trachea would be necessary. We present 6 cases of modified tracheostomy performed with satisfactory results in severe tracheal stenosis that developed in the lower or anterior part of the trachea.

Angiographic embolization for hemorrhage control after dental implantation

  • Hwang, Hee-Don;Kim, Jin-Wook;Kim, Yong-Sun;Kang, Dong-Hun;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.27-30
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    • 2013
  • Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.

Surgical Experience of Pulsed Dye Laser Using Laryngeal Mask Airway Under General Anesthesia in Glottal Papillomatosis Patient who Had Previously Failed to Undergo Surgery Under General Anesthesia Due to Impossible Laryngeal Exposure (전신 마취하 후두 노출이 되지 않았던 후두 유두종 환자에 대하여 시도한 후두 마스크 전신 마취하 Pulsed Dye Laser 수술 치험 1예)

  • Chung, Hyun-Pil;Park, Jun-Hee;Kim, Won-Sik;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.54-57
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    • 2008
  • Non-visualization of larynx is one of the reasons for failure of vocal fold surgery. Many otorhinolaryngologists may have a trouble in choice of alternative treatment if they experience this situation. The laryngeal mask airway could be alternative approach for this situation. We report a glottal papillomatous patient who was treated by pulsed dye laser via laryngeal mask airway after failure of vocal fold surgery via endotracheal intubation. The patient was a 73-year-old man. Laryngoscopy revealed a severe diffuse papillomatous lesion on right true vocal cord, anterior commissure, and partial left true vocal cord. The patient was refered for difficult laryngeal exposure during laryngomicrosurgey under general endotracheal anesthesia.

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A Case Report of Injection Laryngoplasty Who have Difficulty in Neck Extension Using, an I-Gel Laryngeal Mask Airway (경부 신전이 불가한 성대 마비 환자에서 I-Gel$^{TM}$ 후두마스크를 이용한 전신 마취하 성대주입술 증례)

  • Jo, Kwang-Hee;Jung, Chan-Min;Jang, Chul-Ho;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.96-98
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    • 2014
  • Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

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Fiberoptic bronchoscope and C-MAC video laryngoscope assisted nasal-oral tube exchange: two case reports

  • Ji, Sungmi;Song, Jaegyok;Kim, Seok Kon;Kim, Moon-Young;Kim, Sangyun
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.219-223
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    • 2017
  • In cases of multiple facial trauma and other specific cases, the anesthesiologist may be asked to convert an oral endotracheal tube to a nasal endotracheal tube or vice versa. Conventionally, the patient is simply extubated and the endotracheal tube is re-inserted along either the oral or nasal route. However, the task of airway management can become difficult due to surgical trauma or worsening of the airway condition. Fiberoptic bronchoscopy was considered a novel method of airway conversion but this method is not useful when there are secretions and bleeding in the airway, or if the anesthesiologist is inexperienced in using this device. We report a successful airway conversion under the aid of both, a fiberoptic bronchoscope and a C-MAC video laryngoscope.

Manual Reduction of Temporomandibular Joint Long-standing Dislocation under General Anesthesia (전신마취하에 도수정복된 측두하악관절 장기탈구)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Choi, Byung-Ho;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.121-126
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    • 2013
  • Temporomandibular joint (TMJ) dislocation is an acute paintful condition that causes severe functional limitation. So, manual reduction is the treatment of choice and should be performed as early as possible. Long-term dislocation of the TMJ that has persisted for more than 1 month is comparatively rare. This may include severe illness, neurological diseases and prolonged intensive care hospitalization with oral intubation and sedation. A joint that remains prolonged dislocated undergoes morphological change which is also true for periarticular tissue, especially in ligaments and muscles. Treatment of long-term TMJ dislocation should be different from acute TMJ dislocation, as simple reduction is difficult to achieve and it's likely to redislocate. The prevention of redislocation after reduction should be considered. This is a case report of about manual reduction of temporomandibular joint long-standing dislocation under general anesthesia.