調節可能な新型気切カニューレを用いて気道管理しえた頸部蜂窩織炎の1例

Abstract

Airway stenosis during surgery for oral diseases can result in serious complications, thus making airway management one of the most important aspects of perioperative care. A case of buccal cellulitis, in which airway management was performed using a new type of tracheal cannula, is reported. This new type of tracheal cannula is suitable for patients with physical characteristics, such as obesity and swollen cervical tissues that often result in repeated accidental extubation when using a conventional tracheal cannula. The present patient was a female in her 70’s with chief complaints of pain in the right jaw and difficulty breathing. She was examined at her local dental clinic in February, 201X for pain in the right mandibular first molar; however, her symptoms worsened, and she was subsequently examined in the emergency department of our institution. Her current medical history included angina pectoris and IgA nephropathy treated with hemodialysis. On initial examination, her temperature was 37.7°C, and SpO2 was 94%. Breathing difficulty was evident, and marked swelling was observed from the right buccal area to the neck. Right buccal cellulitis was diagnosed clinically, and she was admitted immediately for incisional drainage under general anesthesia. Tracheostomy was then performed. Following repeated accidental extubations of a conventional tracheal cannula, a new type of tracheal cannula was applied, with which good airway management was subsequently achieved.