Utility of Preoperative Anesthesia Clinic Videoendoscopy for Airway Management Planning

AuthorPeter J Kallioen
AuthorAna E Coxen
AuthorPaul S Pagelen
Issued Date2014-10-01en
AbstractIntroduction: The authors performed videolaryngoscopy during the preoperative anesthesia clinic evaluation of a patient with chronic dyspnea, stridor, and a previous hemilaryngectomy scheduled to undergo a series of orthopedic surgery procedures for an infected knee arthroplasty. The findings proved crucial for determining airway management. Case Presentation: A 68-year-old man presented to the preoperative anesthesia clinic for work-up before anticipated removal of infected total knee arthroplasty hardware, placement of antibiotic spacers, incision and drainage procedures, and revision arthroplasty. The patient had previously undergone a hemilaryngectomy and tracheostomy (now closed) for squamous cell carcinoma of the right true vocal cord. The patient described chronic dyspnea with minimal exertion. Inspiratory and expiratory wheezes and intermittent inspiratory stridor were present. A transnasal videolaryngoscopy examination was performed using topical anesthesia and demonstrated significant supraglottic scarring, a narrowed glottis, and subglottic stenosis. A computed tomography study confirmed the presence of tracheomalacia with subglottic stenosis. A permanent tracheostomy was performed to establish a definitive airway before the knee arthroplasty was removed. Conclusions: The case illustrates that transnasal videolaryngoscopy conducted in the preoperative anesthesia clinic is capable of providing key information to guide airway management in patients with significant upper airway pathology.en
DOIhttps://doi.org/10.5812/aapm.19776en
KeywordLaryngoscopyen
KeywordPatient Safetyen
KeywordEndotracheal Intubationen
KeywordTracheostomyen
KeywordVideoendoscopyen
KeywordPreoperative Anesthesia Clinicen
KeywordDifficult Airwayen
KeywordLaryngeal Carcinomaen
PublisherBrieflandsen
TitleUtility of Preoperative Anesthesia Clinic Videoendoscopy for Airway Management Planningen
TypeCase Reporten

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