[Airway Management for Partial Lung Lobectomy in a Patient with Subglottic Stenosis: A Case Report]

Masui. 2016 Nov;65(11):1170-1172.
[Article in Japanese]


We report a case of sub-glottis stenosis encountered during anesthetic induction. A 79 year-old male was scheduled for a right partial lung lobectomy with video assisted thoracic surgery. Significant history includes percutaneous coronary intervention and pacemaker insertion for myocardial infarction, tuberculosis, trache- ostomy and radiation therapy for vocal cord cancer. Difficulty in tracheal intubation was predicted, but chest X-ray and CT scan did not show tracheal steno- sis. General anesthesia was induced smoothly and mask ventilation was easy. The vocal cord was fully exposed by McGRATH® MAC laryngoscope. However, inser- tion of double lumen tube (37 Fr) was impossible because of resistance just under the vocal cords. A membranous subglottic stenosis was found using a flexible bronchoscope. Then we inserted ID 7.0 mm single lumen tube and accomplished differential lung ventilation using a bronchial blocker. Surgery was done smoothly. In spite of recent advances in radiographic imaging, some cases of tracheal stenosis are difficult to diagnose.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthesia, General
  • Bronchoscopy
  • Constriction, Pathologic
  • Glottis
  • Humans
  • Intubation, Intratracheal / methods
  • Laryngoscopes
  • Laryngostenosis*
  • Male
  • Masks
  • Thoracic Surgery, Video-Assisted / methods
  • Trachea
  • Tracheal Stenosis
  • Vocal Cords