Postextubation Airway Obstruction and Negative-pressure Pulmonary Edema Due to a Laryngeal Cyst A case report

발관후 후두 낭종으로 인한 기도폐쇄와 음압성 폐부종 - 증례보고

Kim, Hyun-Jung;Jun, Jong-Hun;Shim, Jae-Hang;Kim, Dong-Won
김현정;전종헌;심재항;김동원

  • Published : 20050200

Abstract

Laryngeal cysts, including epiglottic cysts, are rare lesions which are clinically asymptomatic in many cases. Rarely laryngeal cysts cause unexpected airway management difficultties perioperatively. We report up on a case of laryngeal cyst that caused postextubation airway obstruction and negative-pressure pulmonary edema. A 25-year-old man was admitted for brain surgery with neurofibromatosis. He did not have any specific airway problem preoperatively, and anesthesia was done uneventfully. But when he was extubated after surgery, he revealed symptoms of upper airway obstruction in the recovery room. We reintubated him easily, and then we found a laryngeal cyst. Though negative-pressure pulmonary edema occurred after reintubation, he responded to conservative treatment and was discharged without specific problems. We present a review of postextubation airway obstruction and negative-pressure pulmonary edema due to a laryngeal cyst.

Keywords

References

  1. Arens C, Glanz H, Kleinsasser O: Clinical and morphological aspects of laryngeal cysts. Eur Arch Otorhinolaryngol 1997; 254: 430-6 https://doi.org/10.1007/BF02439974
  2. Henderson LT, Denneny JC 3rd, Teichgraeber J: Airway-obstructing epiglottic cyst. Ann Otol Rhinol Laryngol 1985; 94: 473-6 https://doi.org/10.1177/000348948509400512
  3. Rivo J, Matot I: Asymptomatic vallecular cyst: airway management considerations. J Clin Anesth 2001; 13: 383-6 https://doi.org/10.1016/S0952-8180(01)00277-X
  4. Kamble VA, Lilly RB, Gross JB: Unanticipated difficult intubation as a result of an asymptomatic vallecular cyst. Anesthesiology 1999; 91: 872-3 https://doi.org/10.1097/00000542-199909000-00043
  5. Millar SW: Unexpected difficult intubation. Anaesthesia 1987; 42: 1021-2
  6. McHugh P: Cyst of epiglottis. Anaesthesia 1989; 44: 522
  7. Lang SA, Duncan PG, Shephard DA, Ha HC: Pulmonary oedema associated with airway obstruction. Can J Anaesth 1990; 37: 210-8 https://doi.org/10.1007/BF03005472
  8. Tami TA, Chu F, Wildes TO, Kaplan M: Pulmonary edema and acute upper airway obstruction. Laryngoscope 1986; 96: 506-9 https://doi.org/10.1288/00005537-198605000-00007
  9. Koch SM, Abramson DC, Ford M, Peterson D, Katz J: Bronchoscopic fmdings in post-obstructive pulmonary oedema. Can J Anaesth 1996; 43: 73-6 https://doi.org/10.1007/BF03015962
  10. Bhavani-Shankar K, Hart NS, Mushlin PS: Negative pressure induced airway and pulmonary injury. Can J Anaesth 1997; 44: 78-81 https://doi.org/10.1007/BF03014328
  11. Dolinski SY, MacGregor DA, Scuderi PE: Pulmonary hemorrhage associated with negative-pressure pulmonary edema. Anesthesiology 2000; 93: 888-90 https://doi.org/10.1097/00000542-200009000-00042
  12. Kim YS, Cho SD, Song NW, Lee YK, Jun SH: Noncardiogenic pulmonary edema related to airway obstruction. Korea J Anesthesiol 1993; 26: 1078-83 https://doi.org/10.4097/kjae.1993.26.5.1078
  13. Kwag MJ, Kim AR, Kim JM: Pulmonary edema secondary to laryngospasm after extubation. Korea J Anesthesiol 1997; 32: 1003-7 https://doi.org/10.4097/kjae.1997.32.6.1003