An awake double lumen endotracheal tube intubation using the Clarus Video System in a patient with an epiglottic cyst: a case report / 대한마취과학회지

A 54-year-old male patient was scheduled for an elective pylorus-preserving pancreaticoduodenectomy combined with video-assisted thoracic surgery at our hospital. This patient had a history of intubation failure in other institutions due to an epiglottic cyst. An airway assessment of the patient was normal. A preoperative laryngoscopy revealed a bulging epiglottic mass covering most of the epiglottis and occupying most of the pharyngeal space. The patient was administered intravenous midazolam 1 mg, fentanyl 50 microg, and glycopyrrolate 0.2 mg. A bilateral superior laryngeal nerve block was then performed with 2% lidocaine 2 ml on each side. A 10% lidocaine spray was applied on to the oropharynx. After preoxygenation with 100% oxygen over 10 minutes, a rigid fiberscope with an optical stylet loaded with a 37 Fr double lumen endotracheal tube was inserted orally and passed into the glottic aperture. The patient was fully awakened after surgical procedure and was transferred to the recovery room after extubation.

Laringocele mixto manifestado como una tumoración cervical / Mixed laryngocele evidenced as a lump in the neck

El laringocele es una dilatación llena de aire del sáculo del ventrículo laríngeo originado por un aumento anormal del tamaño del sáculo. La mayoría son asintomáticos y unilaterales, resultando ser hallazgos casuales descubiertos en exploraciones realizadas por otra causa. En la última década ha adquirido una mayor importancia debido: al incremento de su diagnóstico por el uso de TAC, y su asociación con el cáncer de laringe; obligando a descartar una patología tumoral subyacente ante todo laringocele. A pesar de ser una patología laríngea infrecuente y benigna, puede llegar a ser potencialmente letal por el distress ocasionado.

A laryngocele is an air-filled dilatation of the saccule of the laryngeal ventricle originated by an abnormal increase in size of the saccule. Most of them are asymptomatic and unilateral incidental findings found in explorations performed for other reasons. It has become fairly relevant in the lastdecade due to the increased diagnosis by the use of CT scan and its relationship with laryngeal cáncer (well recognised by most authors). This has made it necessary to exclude an underlying neoplasic cause for any laryngocele. In spite of being an infrequent and benign disease it can be potentially lethal due to the associated disturbances.