title: Failed intubating laryngeal mask airway-guided blind endotracheal intubation in a severe postburn contractured neck patient.
abstract: Securing the airway in patients with severe post burn contracture of the neck is often challenging for attending anesthesiologists. Fiberoptic bronchoscope (FOB)-guided endotracheal intubation is considered safe and reliable in this situation. Intubating Laryngeal Mask Airway (ILMA) is an alternative in case of FOB unavailability. We report a case of 30 year old female with mentosternal contracture, where the use of ILMA allowed easy ventilation but failed to enable successful ILMA-guided blind intubation despite multiple attempts, the use of recommended Chandey's maneuver and muscle relaxation. Subsequent FOB revealed marked anterior dislocation of laryngotracheal structures, leading to a slippage of the endotracheal tube back to the esophagus.
authors.affiliation: Department of Anesthesia and Intensive Care, PGIMER, Chandigarh. bhupeshkr@yahoo.com
authors.forename: B
authors.initials: B
authors.lastname: Kumar
authors.forename: K
authors.initials: K
authors.lastname: Vadaje
authors.forename: S
authors.initials: S
authors.lastname: Sethi
authors.forename: A
authors.initials: A
authors.lastname: Singh
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D001999:Bronchoscopy / Q000379:methods*; D002056:Burns / Q000150:complications*; D003286:Contracture / Q000209:etiology*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D017214:Laryngeal Masks; D009333:Neck / Q000601:surgery*; D014132:Trachea / Q000503:physiopathology; D017211:Treatment Failure