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Journal of Case Reports
Unanticipated Difficult Intubation Caused by Unexpected Laryngeal Web in a Case of Bilateral Abductor Palsy

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Sunita Meena, Brajesh Kumar Ratre, Usha Bafna, Mangilal Deganwa
From The Department of Anesthesiology, SMS Medical College and Attached Group of Hospital, Jaipur (Rajasthan), India.
Corresponding Author:
Dr. Brajesh Kumar Ratre
Email: brajesh.ratre@gmail.com
Received: 20-JUN-2014 Accepted: 21-AUG-2014 Published Online: 30-SEP-2014
DOI: http://dx.doi.org/10.17659/01.2014.0093
Abstract
We report a case of unanticipated difficult intubation in a 9 year old child caused by unexpected post-tracheostomy laryngeal web. Patient was scheduled for unilateral arytenoidectomy and cordectomy by CO2 laser. After induction of anaesthesia vocal cords were seen clearly during direct laryngoscopy. Although intubation was attempted several times but tracheal tube could not be passed below the vocal cords. Endoscopic examination by surgeon revealed anterior laryngeal web below the vocal cords. Surgeon decided web excision and cordectomy using CO2 laser. For this patient was intubated with 3 mm ID uncuffed plain red rubber endotracheal tube. For preventing fire, intermittent apnea technique was used. After web excision endotracheal tube was replaced with 4.5 ID uncuffed endotracheal tube for arytenoidectomy and cordectomy. Operating procedure and extubation was uneventful.
Keywords : Intubation, Laryngeal Diseases, Lasers, Tracheostomy, Laryngoscopy, Humans.
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