Airway management for patients with tracheal stenosis and severe scar contracture of the face and neck via bronchoscopy: a case report

J Cardiothorac Surg. 2024 Sep 20;19(1):537. doi: 10.1186/s13019-024-03064-4.

Abstract

Both anaesthesiologists and surgeons experience challenges in managing airway stenosis and scar contracture in the face and neck. Herein, we report the case of a 38-year-old woman (BMI 23.1 kg/m2, third-degree burns covering 40% of her body, an American Society of Anaesthesiologists physical status III) with an unusual case of airway constriction. This patient had a predictable difficult airway (mouth opening of 2 cm, bilateral nostril scar hyperplasia, Mallampatti score III, scarring of the head and neck, and severe tracheal stenosis). Tracheal stenosis measuring 5.5 mm in width as observed 8 cm below the glottis, and the bronchoscope could not pass through it. After two failed attempts at laryngeal mask insertion, we decided to instead insert a custom-made tracheal tube under the guidance of a fiberoptic bronchoscope. The operation was successful, and the patient was transferred to the intensive care unit (ICU).

Keywords: Airway stenosis; Difficult airways; Self-made.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Airway Management* / methods
  • Bronchoscopy* / methods
  • Burns / complications
  • Cicatrix* / surgery
  • Contracture* / surgery
  • Face / surgery
  • Female
  • Humans
  • Intubation, Intratracheal / methods
  • Neck / surgery
  • Tracheal Stenosis* / diagnosis
  • Tracheal Stenosis* / surgery