J Dent Anesth Pain Med.  2019 Oct;19(5):301-306. 10.17245/jdapm.2019.19.5.301.

Airway management of a patient incidentally diagnosed with Mounier-Kuhn syndrome during general anesthesia

• No HJ
• Lee JM
• Won D
• Kang P
• Choi S

• KMID: 2461247
• DOI: http://doi.org/10.17245/jdapm.2019.19.5.301

Abstract

Mounier-Kuhn syndrome (MKS) is a disease characterized by dilation of the trachea and mainstem bronchi. Due to the risk of airway leakage, pulmonary aspiration, and tracheal damage, MKS can be fatal in patients undergoing tracheal intubation. Moreover, MKS may not be diagnosed preoperatively due to its rarity. In this case, a patient undergoing neurosurgery was incidentally diagnosed with MKS during general anesthesia. During anesthesia induction, difficulties in airway management led the anesthesiologist to suspect MKS. Airway leakage was resolved in this case using oropharyngeal gauze packing. Anesthesiologists should be aware of the possibility of MKS and appropriate management of the airways.

Keyword

Airway Management; Intubation, Intratracheal; Mounier-Kuhn Syndrome; Tracheobronchomegaly

MeSH Terms

Airway Management*
Anesthesia
Anesthesia, General*
Bronchi
Humans
Intubation
Intubation, Intratracheal
Neurosurgery
Trachea
Tracheobronchomegaly*

Figure

• 

  Fig. 1 (a) Anteroposterior view of the three-dimensional reconstruction of the thoracic computed tomography (CT) images. There is a relatively un-dilated area of the trachea in the subglottic region of approximately 2 cm in length. (b) Scanogram of preoperative chest CT clearly shows dilation of the trachea. (c) Axial plane of the thoracic CT at point ‘A’ in (a) showing relatively normal tracheal diameter. (d) Axial plane of the thoracic CT at point ‘B’ in (a) showing dilation of the trachea 2 cm above the aortic arch.

• 

  Fig. 2 Three-dimensional reconstruction of the preoperative thoracic computed tomography images showing severe dilation of the trachea and mainstem bronchi. Anteroposterior (left) and lateral (right) views.

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