title: [Perioperative Management of a Child with Vocal Adhesion Leading to Unexpected Difficult Airway].
abstract: We report a child with vocal cord adhesion encountered during induction of anesthesia. A 4-month-old girl was scheduled for bilateral lip plasty. She was intubated for one week due to pneumonia at the age of 3 days. Hoarseness and stridor appeared just after extubation. Although laryngo-fiberoptic examination had been tried several times, otorhinologists could not find any abnormality. We once decided to postpone the operation because of severe stridor. However, laryngofiberoptic examination could not reveal any abnormality, and we rescheduled the operation. Tracheal intubation using laryngoscope was not possible due to vocal cord adhesion. Finally, 2.5 mm ID tracheal tube was intubated by using a fiberscope, and lip plasty was performed. The patient stayed in the ICU for 7 days after surgery. Tracheotomy was performed 3 weeks after the operation. We should pay attention to stridor in an infant before general anesthesia, since it suggests severe airway narrowing although laryngo-fiberoptic examination could not find any abnormalities.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hitosugi
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsukamoto
authors.forename: Shigeki
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoyama
mesh_terms: D000768:Anesthesia, General; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D020704:Laryngoscopes; D007830:Larynx; D019990:Perioperative Care; D012137:Respiratory System / Q000503:physiopathology*; D014140:Tracheotomy; D014827:Vocal Cords / Q000473:pathology*