[Management of postoperative pharyngeal swelling after anterio-posterior cervical fusion under pharyngoscopy].
A 47-year-old man with traumatic cervical spinal cord injury underwent anterio-posterior cervical fusion, which accompanied high-risk of upper airway obstruction by postoperative reactive pharyngeal swelling. After the operation, we ascertained that he had no paralysis of his extremities, and sedation and mechanical ventilation were started at ICU. We evaluated the degree of edema in the hypopharyngeal and supraglottic regions with pharyngoscopy. On postoperative day 3, the direct fiberoptic evaluation showed postoperative swelling of the upper airway. On postoperative day 8, extubation was performed after confirming the healing pharyngeal edema by fibroptic evaluation. To achieve successful extubation, fibroptic pharyngoscopy should show that the pharynx around the endotracheal tube wide enough to see the larynx including epiglottis. Pharyngoscopy is a useful method to evaluate the upper airway.
Yamashita
Kazunori
K
Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo.
Terao
Yoshiaki
Y
Inadomi
Chiaki
C
Takada
Masafumi
M
Fukusaki
Makoto
M
D002574:Cervical Vertebrae / Q000601:surgery*; D004487:Edema / Q000209:etiology / Q000628:therapy*; D004724:Endoscopy; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications; D013123:Spinal Fusion / Q000009:adverse effects*