• Kosin Medical Journal
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• v.33 no.2
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• pp.252-256
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• 2018

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.

• Korean Journal of Bronchoesophagology
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• v.18 no.2
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• pp.41-44
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• 2012

Acquired tracheoesophageal fistula (TEF) can occur rarely from various causes. Recently, cuff-related tracheal injury after endotracheal intubation with the orotracheal tube and tracheostomy cannula is the most common etiology of nonmalignant TEF. Since cuff-related TEF is usually preventable with proper selection of the cuffed tube and close monitoring of cuff pressure. Although most patients present increased secretions, recurrent pneumonia, or coughing after swallowing, a high index of suspicion is required in patients at risk for developing a TEF. Surgical correction for the defectis required. In most cases, primary closure of the esophageal defect and tracheal resection and end-to-end anastomosis give the best results.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.423-425
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• 2013

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.

• The Korean Journal of Emergency Medical Services
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• v.21 no.2
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• pp.7-15
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• 2017

Purpose: This study investigated the effectiveness of education regarding cuff pressure following endotracheal tube intubation using a quasi-experimental design with a pre- and posttest non-equivalent control group. Methods: A total of 78 students from two universities participated in an education intervention on the importance of cuff pressure after endotracheal tube intubation between October and December, 2016. The intervention lasted 40 minutes. Data were collected from each student before the intervention and one week following the intervention. Analyses were conducted using chi-square tests, Fisher's exact tests, and analysis of covariance. Results: A total of 38 students were assigned to the experimental group and 40 to the control group. The educational intervention of cuff pressure following endotracheal tube intubation was associated with prevention of possible complications from excessive cuff pressure (F=121.02, p<.001). Conclusion: Training with a pressure gauge and an intubation manikin is necessary to determine the appropriate cuff pressure in the intubation protocol of the practical examination in the emergency medical technology.

• Journal of the Korea Society of Computer and Information
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• v.25 no.12
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• pp.227-233
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• 2020

The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.130-134
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• 1999

Background and Objectives : Vocal fold paralysis is an unusual complication following endotracheal intubation. We experienced five cases and analyzed their causes and preventions. Materials and Methods : We reviewed 5 cases of vocal fold paralysis following general anesthesia with endotracheal intubation at Ewha Womans University Hospital from September 1997 to May 1999 retrospectively. Results : Four cases were unilateral vocal fold paralysis(3 cases were left side, 1 case was right side) and a case was bilateral vocal fold paralysis. Conclusion : Vocal fold paralysis following endotracheal intubation is the result of recurrent laryngeal nerve damage. This damage can occur as the result of compressing the anterior branch of recurrent laryngeal nerve between an inflated endotracheal tube cuff and thyroid cartilage. Prevention of this complication lies in eliminating the use of endotracheal tubes with cuff inflated unevenly, desisting from the practice of deliberately placing the cuff within the larynx, and filling the cuff with a sample of the inspired mixture of gases.

• Journal of Korean Academy of Nursing
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• v.42 no.1
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• pp.116-124
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• 2012

Purpose: The study was done to compare effects of two endotracheal tube (ET tube) fixation methods (rotated fixation versus conventional) on unplanned extubation and skin integrity for orally intubated patients in intensive care units. Methods: The research design was a non-equivalent control group with repeated measures design. Participants were 80 patients; 40 participants assigned to each group. ET tube for the experimental participants fixed with rotated method every morning. Unplanned extubation was assessed by bedside nurses using the unplanned extubation report form. Oral mucosa and facial skin integrity were assessed using oral assessment guide and facial skin integrity assessment guide at day 3, 7, 10 and 14. Results: There was no difference in the unplanned extubation rate between the two groups. Oral mucosa impairment scores for the rotated fixation method were significantly lower at day 7 (p=.044), 10 (p=.048) and day 14 (p=.037). Also facial skin integrity impairment scores for the same group were significantly lower at day 7 (p=.010), 10 (p=.003), and 14 (p=.002). Conclusion: Results of the study suggest that the rotated fixation method is effective for these patients, to prevent impairment of oral mucosa and facial skin integrity. Further research is needed to prevent unplanned extubation.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1014-1016
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• 1998

Rupture of the bronchus following endotracheal intubation with a double-lumen tube is extremely rare in all complications of endotracheal intubation. We experienced a case of left main bronchial rupture following endotracheal intubation. This 58-year old female patient was diagnosed of well-differentiated adenocarcinoma of right lower lobe, stage IIB, preoperatively. She was intubated with Robertshaw double-lumen tube(35 Fr.) for Rt. lower lobectomy. Intraoperatively, Lt. main bronchial rupture was suspected because of pneumomediastinum and ventilation insufficiency and immediately repaired with monofilament absorbable sutures(PDS) through left thoracotomy. Postoperative course was uneventful.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.219-223
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• 2017

In cases of multiple facial trauma and other specific cases, the anesthesiologist may be asked to convert an oral endotracheal tube to a nasal endotracheal tube or vice versa. Conventionally, the patient is simply extubated and the endotracheal tube is re-inserted along either the oral or nasal route. However, the task of airway management can become difficult due to surgical trauma or worsening of the airway condition. Fiberoptic bronchoscopy was considered a novel method of airway conversion but this method is not useful when there are secretions and bleeding in the airway, or if the anesthesiologist is inexperienced in using this device. We report a successful airway conversion under the aid of both, a fiberoptic bronchoscope and a C-MAC video laryngoscope.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.101-103
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• 2015

In oral and maxillofacial surgery, many complications associated with nasotracheal tube can be caused. In this case, we reported ballooning tube damage of nasotracheal tube during orthognathic double-jaw surgery and replacement of tube through cut down of tube and tube exchange using airway exchange catheter. The patient scheduled for high Le Fort I osteotomy and bilateral sagittal split osteotomy was intubated nasotracheally with nasal endotracheal tube. During maxilla osteotomy, air bubble was detected in the oral blood. In spite of our repeated ballooning, the results were the same so we changed damaged tube using airway exchange catheter aseptically. Tiny and superficial cutting site was detected in the middle of pilot tube. As we know in our case, tiny injury impeded a normal airway management and prevention is important.