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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 381-383
DOI: 10.4103/ajns.AJNS_258_20
Case Report

Endotracheal tube obstruction experienced during an anterior cervical discectomy and fusion

Masahiro Aoyama
1   Department of Neurosurgery, Aichi Medical University, Nagakute
2   Spine Center, Aichi Medical University, Nagakute
,
Masahito Hara
2   Spine Center, Aichi Medical University, Nagakute
,
Ryuya Maejima
1   Department of Neurosurgery, Aichi Medical University, Nagakute
,
Tomoko Kinoshita
3   Department of Anesthesiology, Aichi Medical University, Nagakute
,
Hiroko Aoyama
3   Department of Anesthesiology, Aichi Medical University, Nagakute
,
Shuji Kurokawa
4   Department of Anesthesiology, Konan Kosei Hospital, Konan, Aichi
,
Atsushi Hashimoto
3   Department of Anesthesiology, Aichi Medical University, Nagakute
,
Hiroshi Ito
3   Department of Anesthesiology, Aichi Medical University, Nagakute
,
Yuko Sato
3   Department of Anesthesiology, Aichi Medical University, Nagakute
,
Yoshihiro Fujiwara
3   Department of Anesthesiology, Aichi Medical University, Nagakute
,
Shigeru Miyachi
1   Department of Neurosurgery, Aichi Medical University, Nagakute
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During anterior cervical discectomy and fusion (ACDF), endotracheal tube difficulties are anticipated at the operative level but are unexpected elsewhere in the airway. We report the case of a 66-year-old woman who underwent C4/C5 ACDF to treat adjacent segment disease following a previous anterior cervical fixation surgery. Shortly after her lower jaw was elevated and the fusion cage was inserted, a rise in airway pressure was observed, indicating impaired breathing. Subsequent examination revealed a bent endotracheal tube in the oral cavity as the cause of the respiratory impairment. During anterior cervical surgery, elevating the lower jaw can cause the tongue root to press against the endotracheal tube. Reinforced endotracheal tubes, with a spiral-wound wire in the inner wall, would effectively prevent this issue. In the unlikely event of impaired breathing during such an operation, the oral cavity should be inspected for confirmation of an open airway.

Key-words:

Anterior cervical discectomy and fusion - endotracheal tube - reinforced endotracheal tube

Financial support and sponsorship

Nil.




Publication History

Received: 27 May 2020

Accepted: 15 October 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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