Ludwig's Angina 환자의 어려운 기도 관리에서 기관지내시경과 비디오 후두경의 병용 경험 = Difficult Airway Management with Fiberoptic Bronchoscopy Combined with Video Laryngoscope in a Patient with Ludwig Angina

다국어 초록 (Multilingual Abstract)

We experienced dfficult airway management in a patient who had Ludwig angina with morbid obesity, dfficulty with mouth opening and neck extension. We planned to perform awake-nasotracheal intubation with fiberoptic bronchoscopy but the patient's condition was not suitable to do this procedure. Thus, we tried fiberoptic nasotracheal intubation under general anesthesia but we experienced difficult airway management due to epistaxis. We tried to use video laryngoscope instead of fiberpotic bronchoscopy but also failed to guide the tube into trachea due to limited mouth opening. We used video laryngoscope to make a view of vocal cord and used fiberoptic bronchoscope as an intubation guide of endotrachedal tube and successfully intubated the patient.

참고문헌 (Reference)

1 오세리, "어려운 기관 내 삽관이 예상되는 환자의 기도관리 -증례 보고-" 대한치과마취과학회 10 (10): 190-196, 2010

2 이승현, "비출혈 환자에서 굴곡성 기관지를 이용한 맹목적 기관내 삽관" 대한치과마취과학회 12 (12): 121-123, 2012

3 Cooper RM, "Use of a new videolaryngoscope (GlideScope) in the management of a difficult airway" 50 : 611-613, 2003

4 Potter JK, "Tracheotomy versus endotracheal intubation for airway management in deep neck space infections" 60 : 349-354, 2002

5 Wolfe MM, "Is surgical airway necessary for airway management in deep neck infections and Ludwig angina?" 26 : 11-14, 2011

6 Seo KS, "A new technique to reduce epistaxis and enhance navigability during nasotracheal intubation" 105 : 1420-1424, 2007