title: Difficult oral endotracheal intubation in an acromegalic patient receiving transsphenoidal surgery--a case report.
abstract: Patients suffering from acromegaly are associated with increased risks of difficult airway management. We report a case of acromegaly scheduled for transsphenoidal resection of pituitary adenoma under general anesthesia in whom all possible means failed us in the insertion of the endotracheal tube (ET) through the mouth, a procedure essential for transsphenoidal surgery. The operation was called off and for securing his compromised airway a nasal ET was placed under fiberoptic bronchoscopy. Five days later, awake oral fiberoptic intubation was successful under topical anesthesia. We suggest that oral endotracheal intubation performed awake under topical anesthesia with the aid of a fiberoptic bronchoscope is a choice approach in acromegalic patients with predicated difficult airway who are to receive surgery.
authors.affiliation: Department of Anesthesiologv, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
authors.forename: Sheng-Chin
authors.initials: SC
authors.lastname: Kao
authors.forename: Hung-
authors.initials: H
authors.lastname: Chiou
authors.forename: Jee-Ching
authors.initials: JC
authors.lastname: Hsu
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Lin
authors.forename: Ping-Wing
authors.initials: PW
authors.lastname: Lui
mesh_terms: D000172:Acromegaly / Q000601:surgery*; D001999:Bronchoscopy; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013100:Sphenoid Bone