Perioperative management of a child with vocal adhesion leading to unexpected difficult airway

Takashi Hitosugi, Masanori Tsukamoto, Shigeki Fujiwara, Takeshi Yokoyama

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


We report a child with vocal cord adhesion encountered during induction of anesthesia A 4-month-old girl was scheduled for bilateral lip plasty. She was intubated for one week due to pneumonia at the age of 3 days. Hoarseness and stridor appeared just after extubation. Although laryngo-fiberoptic examination had been tried several times, otorhinologists could not find any abnormality. We once decided to postpone the operation because of severe stridor. However, laryngofiberoptic examination could not reveal any abnormality, and we rescheduled the operation. Tracheal intubation using laryngoscope was not possible due to vocal cord adhesion. Finally, 2.5 mm ID tracheal tube was intubated by using a fiberscope, and lip plasty was performed. The patient stayed in the ICU for 7 days after surgery. Tracheotomy was performed 3 weeks after the operation. We should pay attention to stridor in an infant before general anesthesia, since it suggests severe airway narrowing although laryngo-fiberoptic examination could not find any abnormalities.

Original languageEnglish
Pages (from-to)590-593
Number of pages4
JournalJapanese Journal of Anesthesiology
Issue number6
Publication statusPublished - Jun 2016

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine


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