论文信息 - A case of difficult airway caused by lingual tonsil hyperplasia and epiglottic cyst.

A case of difficult airway caused by lingual tonsil hyperplasia and epiglottic cyst.

術前予測できなかった喉頭蓋嚢腫を伴った舌扁桃肥大による気道確保困難症例を経験した.生来健康な52歳男性に鎖骨骨接合術が予定された.術前気道評価では特に問題を認めなかった.麻酔導入後,マスク換気が困難で2人の麻酔科医を必要とした.喉頭展開したところ,舌根部から喉頭蓋谷にかけて舌扁桃肥大が認められ,喉頭蓋は先端が見えるだけであった.そこで気管支鏡を用いた挿管法に変更したが肥大した舌扁桃のため視野確保は困難であった.挿管用エアウェイと下顎挙上法の援用により,嚢腫を伴った喉頭蓋が確認できた.その後,愛護的に気管支鏡,気管チューブを気管内に進めた.抜管は,ジェットスタイレット法を用いて行い,術後経過は良好であった.舌扁桃肥大と喉頭蓋嚢腫の気道管理について考察した.

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