Abstract

Unanticipated difficult airway is a challenging problem for anesthesiologists. Oropharyngeal stenosis (OPS) is a rare complication of upper airway surgery which may cause difficult airway. We present a patient whose postsurgical OPS was revealed during the induction of general anesthesia, and necessitated reschedule of surgery and tracheotomy. We also discuss the etiology and risk factors of postsurgical OPS.

Highlights

  • An unexpected difficult airway during the induction of general anesthesia is a condition that is best avoided

  • Anatomical factors indicative of difficult airway include high body mass index, older age, Mallampati grade III or IV, severely limited jaw protrusion, and thyromental distance of less than 6 cm [1]. Even those predictors could fail at predicting difficult laryngoscope

  • We present a case of unexpected difficult intubation due to undiagnosed oropharyngeal stenosis (OPS)

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Summary

Background

An unexpected difficult airway during the induction of general anesthesia is a condition that is best avoided. Anatomical factors indicative of difficult airway include high body mass index, older age, Mallampati grade III or IV, severely limited jaw protrusion, and thyromental distance of less than 6 cm [1]. An interpreter (a Japanese nurse who spoke some Chinese) helped us with the preanesthesia visit, a detailed interview was unable She was classified as Mallampati IV (uvula not visible), but we did not find other factors indicative of a difficult airway Sugammadex 200 mg was administered, and spontaneous respiration was resumed within five minutes She came out of anesthesia without difficulty breathing and was sent back to the ward. The difficulty of respiratory management using a tracheal tube of less than 6 mm of outer diameter (which means an inner diameter of 4 to 4.5 mm) and

Discussion
Conclusions
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