title: Endotracheal tube intubation with the aid of a laryngeal mask airway, a fiberoptic bronchoscope, and a tube exchanger in a difficult airway patient: a case report.
abstract: A 28-year-old male patient with occipito-atlanto-axial instability underwent a cervical fusion with posterior technique. Post-operatively, the endotracheal tube (ETT) was removed, and the patient was transferred to the intensive care unit. After transfer, an upper airway obstruction developed and reintubations with a laryngoscope were attempted but failed. We inserted a #4 proseal laryngeal mask airway (LMA) and passed a 5.0 mm ETT through the LMA with the aid of a fiberoptic bronchoscope. We passed a tube exchanger through the 5.0 mm ETT and exchanged it with a 7.5 mm ETT. This method may be a useful alternative for difficult tracheal intubations.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Graduate School, Kyung Hee Medical University, Seoul, Korea.
authors.forename: Joon Kyung
authors.initials: JK
authors.lastname: Sung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, Korea.
authors.forename: Hyung Gon
authors.initials: HG
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Graduate School, Kyung Hee Medical University, Seoul, Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Seoul, Korea.
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Jang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Jong-Man
authors.initials: JM
authors.lastname: Kang
keywords: Airway obstruction; Bronchoscopes; Cervical vertebrae; Laryngeal masks; Spinal fusion; Tube exchanger
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