Successful endotracheal intubation with Trachway after failed fiber-optic manipulations in a patient with retropharyngeal cervical chordoma

A retropharyngeal mass may distort the airway anatomy and reduce the space available for manipulation of intubation devices. We encountered a patient with a cervical chordoma occupying the retropharyngeal space. Fiber-optic orotracheal intubation was attempted to secure the airway. Although the fibe...

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Bibliographic Details
Main Authors: Yi-Ting Chen, Chun-Ning Ho, Kuo-Chuan Hung
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Tzu Chi Medical Journal
Subjects:
Online Access:http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=3;spage=174;epage=176;aulast=Chen
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Summary:A retropharyngeal mass may distort the airway anatomy and reduce the space available for manipulation of intubation devices. We encountered a patient with a cervical chordoma occupying the retropharyngeal space. Fiber-optic orotracheal intubation was attempted to secure the airway. Although the fiber-optic bronchoscope (FOB) was successfully placed into the trachea, the tracheal tube could not be passed through the glottis. An airway was then successfully established with the Trachway device, a video-assisted system with a rigid but malleable intubating stylet. In conclusion, although a FOB is commonly used to secure a difficult airway, the present case report demonstrates that fiber-optic intubation is not always successful. Video intubation devices with a rigid stylet (such as Trachway) may be helpful in patients with a cervical chordoma. We suggest this device be available as backup for patients with distorted airway anatomy.
ISSN:1016-3190
2223-8956