Difficult Airway Management with Fiberoptic Bronchoscopy Combined with Video Laryngoscope in a Patient with Ludwig Angina

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.

Ludwig's Angina 환자의 어려운 기도 관리에서 기관지내시경과 비디오 후두경의 병용 경험