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Unexpected difficult intubation caused by a laryngeal web
Authors:Nakamura Y  Kurasako N  Iwaki T  Fukushima T  Ishizu T  Tanaka T  Kosogabe Y  Tokioka H
Institution:Department of Anesthesiology, Okayama Rosai Hospital, Okayama 702-8055.
Abstract:We report a case of unexpected difficult intubation in an adult caused by a laryngeal web. A 43-year-old woman with uterine myoma was scheduled for abdominal hysterectomy. After induction of anesthesia, the vocal cords were seen clearly under laryngoscopy. Although intubation was attempted several times, a 6.5 mm internal diameter tracheal tube could not be passed below the level of the vocal cords because of resistance, and we used a laryngeal mask during anesthesia. Next morning after the operation, she developed dyspnea. Bronchoscopy revealed a very narrow airway below the level of vocal cords caused by a laryngeal web. Tracheostomy was performed. Two weeks later, tracheostomy was closed without any sequela.
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