title: A severe complication after laser-induced damage to a transtracheal catheter during endoscopic laryngeal microsurgery.
abstract: Subcutaneous emphysema and pneumothorax is a rare and severe complication of percutaneous transtracheal jet ventilation, usually caused by obstruction of the upper airway or displacement of the tracheal catheter. Nevertheless, it is our preferred technique for endoscopic laryngeal laser surgery. We report a patient with acute subcutaneous emphysema and pneumothorax during laser surgery, caused by unobserved laser damage and discuss the associated risk factors.
  
  
  CONCLUSIONS
  The percutaneous transtracheal jet ventilation for elective laryngeal laser surgery reduces the risk of airway fires and gives a free endoscopic operative field. This case report suggests that, even when using a teflon catheter, laser-induced damage with severe complications might occur.
authors.affiliation: Departments of *Anesthesiology and †Ear, Nose, Throat, Head, and Neck Surgery, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.
authors.forename: Bettina
authors.initials: B
authors.lastname: Leemann
authors.forename: Thomas
authors.initials: T
authors.lastname: Heidegger
authors.forename: Rudolf
authors.initials: R
authors.lastname: Grossenbacher
authors.forename: Thomas
authors.initials: T
authors.lastname: Schnider
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Gerig
mesh_terms: D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D013352:Subcutaneous Emphysema / Q000175:diagnosis / Q000209:etiology; D014132:Trachea / Q000601:surgery*