Management of difficult intubation in the case with substernal goiter underwent cardiac surgery

Abstract

Redo thyroid surgery is difficult for several reasons and may be complicated. In some cases airway management can be more difficult unexpectedly. In this situation, special airway devices may be required. Here we present a case of a 67-year-old female patient who suffer from recurrent substernal goiter and has dyspnea, cough, and fatigue. In this case, difficult intubation was managed with a gum elastic bougie that was placed into the classical laryngeal mask airway. Laryngeal mask airway was removed while gum elastic bougie was left in place to guide endotracheal tube insertion. The endotracheal tube was slipped over gum elastic bougie. In cases of difficult intubation, endotracheal intubation can be achieved with the guidance of  gum elastic bougie placed through the laryngeal mask airway.

Keywords

• Difficult intubation,substernal goiter,laryngeal mask airway,gum elastic bougie

Kalp cerrahisi geçirmiş olan substernal guatr olgusunda zor entübasyon yönetimi

Abstract

Redo tiroid cerrahisi çeşitli nedenlerle zor ve karmaşık olabilir. Bazı olgularda hava yolu yönetimi beklenmedik şekilde zorluklarla karşılaşılabilir. Bu durumda özel hava yolu cihazları gerekebilir. Biz bu olgu sunumunda, 67 yaşında, solunum sıkıntısı, öksürük ve yorgunluk yakınmaları olan tekrarlayan substernal guatr tanısı olan kadın hastayı sunduk. Bu olguda zor entübasyonu yönetmek için klasik laringeal maske hava yolu içine gum elastik buji yerleştirildi. Endotrakeal tüp yerleştirmeye kılavuz olması için gum elastik buji yerinde bırakılırken laringeal maske hava yolu çıkarıldı. Gum elastik buji üzerinden kaydırılarak endotrakeal tüp yerleştirildi. Zor entübasyon olgularında, laringeal maske hava yolu içinden yerleştirilen gum elastik buji ile endotrakeal entübasyon başarılabilir.

Keywords

• Zor entübasyon,substernal guatr,laringeal maske havayolu,gum elastik buji

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