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Fibreoptic intubation in cicatricial membranes of the pharynx
Author(s) -
DIVATIA J. V.,
UPADHYE S. M.,
SAREEN R.
Publication year - 1992
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1992.tb02271.x
Subject(s) - medicine , intubation , pharynx , larynx , airway , hyperventilation , bronchoscopy , surgery , tracheal tube , airway obstruction , anesthesia
Summary Two patients presented with almost total obliteration of the pharynx. In one, a membrane developed after corrosive poisoning; in the other, the oropharynx was filled with a dense cicatrix in the sclerosing phase of rhinoscleroma. In both patients, a single opening in the membrane provided access to both the larynx and oesophagus. Fibreoptic intubation allowed both a thorough assessment of the pathology and subsequently the passage of a cuffed tracheal tube to secure the airway. To overcome the problem of respiratory obstruction while thefibrescope passed through the opening in the membrane, either rapid intubation, or a technique using pre‐oxygenation and voluntary hyperventilation followed by breath‐holding during bronchoscopy, was used. The thin calibre and manoeuvrability of the flexible fibreoptic bronchoscope makes fibreoptic intubation an excellent technique of airway management in cicatricial membranes of the pharynx.