title: Bilateral vocal cord edema following anterior cervical discectomy-usefulness of bonfils retromolar fiberscope.
abstract: We present a case of a 40-year-old male patient who presented to us with radicular pain in arm for anterior cervical discectomy with fusion. The preanesthetic checkup including indirect laryngoscopy was normal with routine investigations within normal limits. The patient was induced and intubated with the established routine technique without any obvious airway problems. Prophylactic dexamethasone was administered, and the intraoperative course was uneventful. Immediately after extubation, it was noticed that the patient had inspiratory stridor and whispered voice on the operation theater table itself. Assessment by Bonfils retromolar fiberscope under fentanyl sedation revealed bilateral vocal cord edema. The patient was re intubated and put on T piece with humidified O2. After 72-h, patient was extubated after confirming normal vocal cord movement under flexible fiberscope guidance. This case is presented to alert anesthesiologist about the possibility of vocal cord edema even though other potential airway complications are possible. We would also highlight the importance of Bonfils retromolar fiberscope in awake vocal cord examination and flexible fiberscope use in managing patients presenting with airway problems during extubation.
authors.affiliation: Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Puducherry, India.
authors.forename: V R Hemanth
authors.initials: VR
authors.lastname: Kumar
authors.affiliation: Department of Anaesthesiology, IGMCRI, Puducherry, India.
authors.forename: D K
authors.initials: DK
authors.lastname: Tripathy
authors.affiliation: Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Puducherry, India.
authors.forename: T
authors.initials: T
authors.lastname: Sivashanmugam
authors.affiliation: Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Puducherry, India.
authors.forename: M
authors.initials: M
authors.lastname: Ravishankar
keywords: Anterior cervical discectomy; Bonfils retromolar scope; flexible fiberscope; vocal cord edema