RESUMEN
Acquired subglottic cysts are an unusual cause of stridor. They are usually developed following a tracheal intubation episode in a premature patient. We report the clinical case of an ex-premature patient who was diagnosed as having an acquired subglottic cyst after causing a difficult intubation situation. This situation can potentially uncover the obstruction and initiate the complete diagnostic and therapeutic process.
Una causa poco frecuente de estridor laríngeo corresponde a quistes subglóticos. En general se desarrollan luego de una intubación en un paciente prematuro. Se presenta el caso clínico de un ex prematuro que presenta una intubación difícil dada por la presencia de un quiste subglótico. Gracias a esta situación, se inició el estudio y tratamiento del quiste.
Asunto(s)
Humanos , Lactante , Enfermedades de la Tráquea/diagnóstico , Quistes/diagnóstico , Manejo de la Vía Aérea , Enfermedades del Prematuro , Enfermedades de la Tráquea/cirugía , Broncoscopía , Quistes/cirugía , Glotis , Intubación Intratraqueal , LaringoscopíaRESUMEN
Lung isolation in thoracic surgery is a challenge, this is even more complex in the presence of unknown tracheal stenosis (TS). We report two cases of unknown TS and its airway management. TS appears most frequently after long term intubation close to the endotracheal tube cuff or in the stoma of tracheostomy that appears as a consequence of the granulation tissue after the surgical opening of the trachea. Clinical history, physical examination, difficult intubating predictors and imaging tests (CT scans) are crucial, however most of tracheal stenosis may be unnoticed and symptoms depend on the degree of obstruction. In our cases, the patients presented anatomical changes due to surgery and previous tracheostomy that led to a TS without symptoms. There is scarce literature about the intubation in patients with previous tracheostomy in thoracic surgery. In the first case, a Univent® tube was used using a flexible fiberscope but an acute tracheal hemorrhage occurred. In the second case, after intubation with VivaSight SL® in an awake patient, the insertion of a bronchial blocker was performed through an endotracheal tube guided by its integrated camera without using flexible fiberscopy.