title: [Obstructive laryngeal disease and obstructive sleep apnoea syndrome, a combination with serious peri-operative risk].
abstract: We present the case of a patient who was diagnosed with chronic bronchitis, obstructive sleep apnoea syndrome, and large Reinke laryngeal oedemas that were removed by transoral laser microsurgery. In the immediate post-operative period acute respiratory insufficiency occurred due to pharyngeal collapse that required emergency re-intubation, after which the patient was transferred to the ICU where mechanical ventilation was given for 18h. Subsequent progress was normal. We describe the combination of various risk-factors related to anaesthetic management and the importance of considering each one of them, especially the preoperative detection of the severity of obstructive sleep apnoea syndrome.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Clínic Universitari de Barcelona, Barcelona, España. Electronic address: maayuso@clinic.ub.es.
authors.forename: M A
authors.initials: MA
authors.lastname: Ayuso
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Clínic Universitari de Barcelona, Barcelona, España.
authors.forename: G
authors.initials: G
authors.lastname: Sánchez-Etayo
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Clínic Universitari de Barcelona, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Polanco
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Clínic Universitari de Barcelona, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Risco
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000209:etiology*; D029481:Bronchitis, Chronic / Q000150:complications*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000209:etiology* / Q000628:therapy; D007442:Intubation, Intratracheal / Q000379:methods*; D007819:Laryngeal Edema / Q000150:complications* / Q000601:surgery; D007828:Laryngoscopy / Q000379:methods; D053685:Laser Therapy; D008866:Microsurgery; D009765:Obesity / Q000150:complications; D019990:Perioperative Care / Q000379:methods*; D010609:Pharyngeal Muscles / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D012121:Respiration, Artificial; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D014827:Vocal Cords / Q000601:surgery*
keywords: Airway extubation; Airway obstruction; Apnea obstructiva del sueño; Complicaciones; Complications; Edema laríngeo; Extubación traqueal; Intubación; Intubation; Laryngeal oedema; Obstrucción de las vías aéreas; Obstructive sleep apnoea; Post-operative; Postoperatorio