Unexpected difficult tracheal intubation secondary to subglottic stenosis leading to emergency front‐of‐neck airway

Summary A 26‐year‐old woman presenting for an elective day case procedure under general anaesthesia had undiagnosed subglottic stenosis leading to a life threatening airway emergency requiring emergency front‐of‐neck airway. We outline the case and discuss key anaesthetic considerations in subglotti...

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Veröffentlicht in:Anaesthesia reports 2021-01, Vol.9 (1), p.90-94
Hauptverfasser: Ellis, H., Iliff, H. A., Lahloub, F. M. F., Smith, D. R. K., Rees, G. J.
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Sprache:eng
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Zusammenfassung:Summary A 26‐year‐old woman presenting for an elective day case procedure under general anaesthesia had undiagnosed subglottic stenosis leading to a life threatening airway emergency requiring emergency front‐of‐neck airway. We outline the case and discuss key anaesthetic considerations in subglottic stenosis, including concerning features of a medical/anaesthetic history and the potential for rapid deterioration of a stenotic airway following manipulation. We also consider the effect of anaesthesia on the calibre of subglottic stenosis and the effects of positive pressure ventilation. Subglottic stenosis is a rare condition with congenital, acquired and idiopathic origins; however, iatrogenic trauma is the most common cause. We are aware of a small number of published case reports of previously undiagnosed subglottic stenosis in adults discovered after induction of anaesthesia; situational deterioration to ‘cannot intubate, cannot oxygenate’ scenarios appear even rarer.
ISSN:2637-3726
2637-3726
DOI:10.1002/anr3.12115