Fibreoptic intubation in cicatricial membranes of the pharynx.
Two patients presented with almost total obliteration of the pharynx. In one, a membrane developed after corrosive poisoning; in the other, the oropharynx was filled with a dense cicatrix in the sclerosing phase of rhinoscleroma. In both patients, a single opening in the membrane provided access to both the larynx and oesophagus. Fibreoptic intubation allowed both a thorough assessment of the pathology and subsequently the passage of a cuffed tracheal tube to secure the airway. To overcome the problem of respiratory obstruction while the fibrescope passed through the opening in the membrane, either rapid intubation, or a technique using pre-oxygenation and voluntary hyperventilation followed by breath-holding during bronchoscopy, was used. The thin calibre and manoeuvrability of the flexible fibreoptic bronchoscope makes fibreoptic intubation an excellent technique of airway management in cicatricial membranes of the pharynx.
Divatia
J V
JV
Department of Anaesthesia, Tata Memorial Hospital, Bombay, India.
Upadhye
S M
SM
Sareen
R
R
D000328:Adult; D000402:Airway Obstruction / Q000517:prevention & control; D002057:Burns, Chemical / Q000150:complications; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000209:etiology / Q000601:surgery*; D012226:Rhinoscleroma / Q000150:complications