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  • 标题:Difficult Intubation due to Low Located and Right Deviated Thyroid Cartilage: A case report
  • 本地全文:下载
  • 作者:Park, Chan Hong ; Kim, Ho Young ; Rho, Woon Seok
  • 期刊名称:Korean Journal of Anesthesiology
  • 印刷版ISSN:2005-6419
  • 出版年度:2006
  • 卷号:51
  • 期号:6
  • 页码:742-745
  • DOI:10.4097/kjae.2006.51.6.742
  • 语种:English
  • 出版社:The Korean Society of Anesthesiologists,
  • 摘要:

    We report a case of difficult intubation due to a low located thyroid cartilage and a left deviated glottis abnormality. A 35-year-old woman was scheduled to undergo a laminectomy and discectomy for a L4-5 disc herniation. After injecting intravenous induction agents and muscle relaxant, intubation was attempted with a direct laryngoscope. However, no vocal cords were seen and only the epiglottis was seen albeit only slightly. According to Cormack and Lehane's grading, the patient was grade III. Although intubation was re-attempted after changing the anesthesiologist and device such as a light wand, the endotracheal tube could not be advanced below the epiglottis because of resistance. When patient was rechecked, her thyroid cartilage was located abnormally low and the thyromental distance was 14.5 cm. In addition, the preoperative chest X-ray revealed her airway to be deviated to the left. Intubation could be successfully performed after additional 100% oxygen mask ventilation. An otolaryngologic examination revealed that the glottic opening was deviated to the left, and ventricle of the larynx, which is normally not seen with a laryngocope was located to the center. It is believed that the reason for resistance of the advancing endotracheal tube was a centrally located ventricle of the larynx.

  • 关键词:Difficult intubation; thyromental distance; ventricle of the larynx
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