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Securing the Airway in a Patient with Massive neck Swelling, Emergency Tracheostomy: A Technical Note

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Abstract

Objective

To describe the technical aspects of emergency tracheostomy in a case of extensive neck swelling with a challenging airway.

Methods

We report a case of difficult tracheostomy in a patient with a huge neck swelling causing obscured anatomical landmarks in significant stridor. A literature review was performed to identify similar cases or techniques.

Results

Emergency tracheostomy was successfully executed with the help of clinical acumen, imaging findings and intra-operative ultrasound usage.

Conclusions

We describe a safe and effective technique of emergency tracheostomy in patients with huge neck swelling and obscured anatomical landmarks. Collaboration of surgeon with the anaesthesia service is of paramount importance in dealing with challenging airways.

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References

  1. Cheng E, Thorpe E (2016 Nov) A Unique Surgical technique for Tracheostomy in Heterotopic Ossification: a Case Report. Ann Otol Rhinol Laryngol 125(11):943–946

  2. Cankar Dal H (2022 Aug) Difficult airway management and emergency tracheostomy in a patient with giant goiter presenting with respiratory arrest: a case report. Exp Ther Med 24(2):499

  3. Hwang SM, Jang JS, Yoo JI, Kwon HK, Lee SK, Lee JJ et al (2011 Jun) Difficult tracheostomy tube placement in an obese patient with a short neck -A case report-. Korean J Anesthesiol 60(6):434–436

  4. Raskin J, Borrelli M, Nasrollahi T, Heaton C (2022 Dec) Tracheal rupture after Tracheostomy Tube Exchange in a patient with recurrent oral cavity spindle cell carcinoma. Ear Nose Throat J 101(10suppl):15S–18S

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Division of Head and Neck oncology, Dept. of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute, Banjara hills Rd No 14, Hyderabad, 500034, India

    A. Anil kumar & Sravan Kumar Ch.

  2. Department of Anaesthesia and Critical Care, of Head and Neck oncology, Dept. of Surgical Oncology, Basavatarakam Indo American cancer Hospital and Research Institute, Basavatarakam Indo American cancer Hospital and Research Institute, Banjara hills Rd No 14, Hyderabad, 500034, India

    Sushma Konduri

Authors
  1. A. Anil kumar
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  2. Sravan Kumar Ch.
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  3. Sushma Konduri
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Corresponding author

Correspondence to Sravan Kumar Ch..

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Anil kumar, A., Kumar Ch., S. & Konduri, S. Securing the Airway in a Patient with Massive neck Swelling, Emergency Tracheostomy: A Technical Note. Indian J Otolaryngol Head Neck Surg 75, 2664–2666 (2023). https://doi.org/10.1007/s12070-023-03712-6

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  • DOI: https://doi.org/10.1007/s12070-023-03712-6

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