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Laringealni hondrosarkom: uspješna primjena videolaringoskopa u zbrinjavanju očekivanog otežanog dišnog puta

机译:喉软骨肉瘤:视频喉镜在预期阻塞性气道管理中的成功应用

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摘要

Laryngeal chondrosarcoma is a rare mesenchymal tumor, most frequently affecting cricoid cartilage. The objective of this report is to present successful video laryngoscope usage in a patient with anticipated difficult airway who refused awake fiberoptic endotracheal intubation (AFOI). A 59-year-old male patient was admitted in our hospital due to difficulty breathing and swallowing. On clinical examination performed by ENT surgeon, preoperative endoscopic airway examination (PEAE) could not be performed properly due to the patient’s uncooperativeness. Computed tomography revealed a spherical tumor that obstructed the subglottic area almost entirely. Due to the narrowed airway, the first choice for the anticipated difficult airway management was AFOI, which the patient refused. Consequently, we decided to perform endotracheal intubation with indirect laryngoscope using a C-MAC video laryngoscope (Karl Storz, Tuttlingen, Germany). Reinforced endotracheal tube (6.0 mm internal diameter) was placed gently between the tumor mass and the posterior wall of the trachea in the first attempt. Confirmation of endotracheal intubation was done by capnography. In a patient with subglottic area chondrosarcoma refusing PEAE and AFOI, video laryngoscope is a particularly helpful device for difficult airway management when difficult airway is anticipated.
机译:喉软骨肉瘤是一种罕见的间质肿瘤,最常影响环状软骨。本报告的目的是介绍成功的视频喉镜在拒绝呼吸清醒的气管插管(AFOI)的预期气道困难患者中的用法。我院一名59岁男性患者因呼吸困难和吞咽而入院。在耳鼻喉科医生进行的临床检查中,由于患者的不合作,术前内镜气道检查(PEAE)无法正确进行。计算机断层扫描显示球形肿瘤几乎完全阻塞了声门下区域。由于气道狭窄,预期的困难气道管理的首选是AFOI,患者拒绝了。因此,我们决定使用C-MAC视频喉镜(Karl Storz,德国图特林根)使用间接喉镜进行气管插管。第一次尝试将增强的气管插管(内径6.0 mm)轻轻地放在肿瘤块与气管后壁之间。通过二氧化碳描记术确认气管插管。对于声门下软骨肉瘤拒绝PEAE和AFOI的患者,视频喉镜对于预期困难气道的困难气道管理特别有用。

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