A Case of Sudden Airway Obstruction due to Pendular Laryngeal Granuloma during Anesthesia Induction.

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  • 麻酔導入直後の換気不全から巨大喉頭肉芽腫が発見された１例

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Abstract

A 54-yr-old woman underwent partial resection of an astrocytoma of the left frontal lobe. There were no obvious complications. Three months later, she visited the neurosurgical department of our hospital for sudden unconsciousness and dysphonia. Computed tomography of the brain showed recurrence of the tumor with a cyst. Ommaya reservoir placement for drainage was scheduled. Shortly after rapid sequence induction of anesthesia with iv. thiopental, fentanyl and vecuronium, ventilation suddenly became impossible. After blind intubation, however, ventilation became easy and was adequate. The surgery and anesthesia were uneventful. We performed an endoscopic examination after tracheal extubation, and found a large pendular laryngeal granuloma. Laryngeal granuloma is a complication associated with prolonged endotracheal intubation, but there are no typical symptoms. The presence of laryngeal granuloma could not be determined from the clinical sign of dysphonia, considering it is the signs of brain tumor recurrence.

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