Soonchunhyang Med Sci.  2019 Jun;25(1):62-64. 10.0000/sms.2019.25.1.62.

Unanticipated Difficult Intubation in Patient with Undiagnosed Posterior Glottic Stenosis

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. misoonlee04@gmail.com

Abstract

Posterior glottic stenosis (PGS) is frequently caused by prolonged intubation complications, which may limit the movement of the vocal cords and obstruct airway obstruction. Despite of a life-threatening condition, it might be overlooked in asymptomatic individual. A 63-year-old female was scheduled for arthroscopic rotator cuff repair. The patient had experienced 2 times of intubation and organophosphate poisoning for suicide. Both of 7.0- and 6.5-mm inner diameter endotracheal tubes could not be passed vocal cords. After two failed attempts at intubation, adhesion of posterior part of vocal cord was revealed. We stopped the tracheal intubation and called the otolaryngologist, and adhesiolysis was performed under direct laryngosope. Thereafter, endotracheal intubation was performed successfully with 6.5-mm endotracheal tube.

Keyword

Difficult intubation; Posterior glottic stenosis; Airway management
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