Difficult Airway caused by a Subglottic Tumor: A Case Report

Abstract

Background: Securing the airway is a core skill for an anesthesiologist, the gold standard of which is tracheal intubation. Patient with subglottic tumor is a situation of difficult airways and could be a challenge for anesthesiologists. The “cannot ventilate, cannot intubate” during anesthesia induction can be lethal. So we always prepared awake approach for diagnosed difficult airway, but awake fiberoptic intubation may be also failed. Case presentation: In this case report we present a 55 years old female patient was scheduled for laryngeal tumor resection, and was planned awake intubation guided by fiber bronchoscope. After awake intubation attempt failed, emergency tracheostomy was successfully completed by ENT surgeon. After securing airway, general anesthesia was performed and the operation proceeded with laryngeal tumor resection. Conclusions: It is important that ENT surgeon must be asked to remain standby for possible need of emergency tracheostomy to prevent awake fiberoptic intubation failure. Ultrasound or computed tomography scan examination of the trachea may be useful to provide guidance for anesthesiologists to choose the appropriate endotracheal tube IDs or tracheostomy directly by measuringthe degree of airway stenosis. Keywords: Subglottic Tumor; difficult airway; ENT; anesthesia