Management of difficult airway in intratracheal tumor surgery

Goyal, Amit; Tyagi, Isha; Tewari, Prabhat; Agarwal, Surendra Kumar; Syal, Rajan

doi:10.1186/1472-6815-5-4

Cited by 16 publications

(11 citation statements)

References 7 publications

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“…The symptoms with subglottic or tracheal tumor include prolonged cough and wheezing. It can be misdiagnosed as asthma (Garas and McGuirt, 2006;Dahm et al, 1998;Kokturk et al, 2005;Goyal et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

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Subglottic adenoid cystic carcinoma mistaken for asthma

Wang

2009

J. Zhejiang Univ. Sci. B

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Adenoid cystic carcinoma rarely occurs within the subglottic larynx. In this study, a case of subglottic adenoid cystic carcinoma was reported. A 54 year-old Chinese woman developed a sudden onset of chest distress and cough worsening after physical exertion, and was diagnosed with, and treated as, bronchial asthma. Regular anti-asthmatic therapy did not improve the symptoms. Until a sudden dyspnea, a cervicothoracic computerized tomography (CT) revealed that her upper airway was obstructed by a laryngeal tumor. The patient was diagnosed with a subglottic adenoid cystic carcinoma and treated with complete surgical excision and adjuvant radiation therapy. Follow-up endoscopy and laryngeal magnetic resonance imaging (MRI) at six months showed no recurrence of the tumor. The diagnosis of subglottic adenoid cystic carcinoma should be considered in patients who are characterized by dyspnea, cough, and stridor, but do not respond to regular anti-asthmatic therapy.

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Section: Discussionmentioning

confidence: 99%

“…It usually becomes symptomatic when it starts occluding more than 75% of the lumen (Goyal et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Subglottic adenoid cystic carcinoma mistaken for asthma

Wang

2009

J. Zhejiang Univ. Sci. B

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“…Goyal et al 5 reported successfully treating a patient with a tracheal tumor occupying about 90% of the tracheal lumen by surgical excision under femoral-femoral CPB. Byrne et al 6 concluded that the planned use of CPB is safe for complete resection of thoracic malignancies and in the event of injury to vascular structures during tumor resection.…”

Section: Discussionmentioning

confidence: 98%

Endoscopic Resection of Tracheal Tumor in an Elderly Woman Under Extracorporeal Membrane Oxygenation

Chiang¹,

Ke²,

Wu³

et al. 2011

International Journal of Gerontology

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s u m m a r yAnesthetic management of patients with difficult airway is challenging, especially in patients who present with near total occlusion of the airway. Tracheal tumors occur more frequently in elderly patients who are more prone to hypoxic injury. Reliable ventilation and oxygenation are mandatory for a safe and sound intervention. Herein, we report on a 71-year-old woman with a large tracheal tumor occluding approximately 90% of the tracheal lumen. Extracorporeal membrane oxygenation under local anesthesia was used during electrocautery resection of the tumor because of the possibility of fatal airway collapse due to the degree of occlusion and location of the tumor. After the tumor had been successfully resected by means of bronchoscopy, an endotracheal tube was inserted, and the patient was weaned from extracorporeal membrane oxygenation.

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“…In case of complete tracheal blockage and severe breathing problems, extracorporeal membrane oxygenation should be considered. 6 – 8 Here, because the mass induced partial obstruction of the tracheal lumen and preoperative images showed its confinement within the endoluminal cavity of the trachea with no visible extra tracheal extension, anesthetic induction and placement of the endotracheal tube could be considered. There are two potential ways to insert the tube tip above or below the mass during anesthetic induction.…”

Section: Discussionmentioning

confidence: 99%

Airway management in a patient with an intratracheal tumor near the carina by a two-stage operation

Kim

2021

SAGE Open Medical Case Reports

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In patients with intratracheal tumors, airway management while maintaining oxygenation and providing surgical access to the airway can be challenging. Here, we present a case of a two-stage operation to remove an intratracheal tumor causing partial obstruction near the carina. In the otorhinolaryngology department, a biopsy was performed during apnea under high-flow nasal oxygenation support. A few days later, a thoracic surgeon performed tracheal resection after sternotomy under general anesthesia. Mechanical ventilation was performed by inserting a sterile endotracheal tube in the resected distal part of the trachea in the surgical field for tracheal end-to-end anastomosis. Airway was successfully secured through close communication between teams of anesthesiologists and surgeons.

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Management of difficult airway in intratracheal tumor surgery

Cited by 16 publications

References 7 publications

Subglottic adenoid cystic carcinoma mistaken for asthma

Subglottic adenoid cystic carcinoma mistaken for asthma

Endoscopic Resection of Tracheal Tumor in an Elderly Woman Under Extracorporeal Membrane Oxygenation

Airway management in a patient with an intratracheal tumor near the carina by a two-stage operation

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