Asymptomatic Subglottic Stenosis Discovered During Anesthesia Induction and Not Predicted by Preoperative Evaluation: A Case Report

TL;DR

A 74-year-old woman had asymptomatic subglottic stenosis discovered during anesthesia, highlighting the need for alternative airway management strategies.

Contribution

Reports a case of asymptomatic subglottic stenosis detected during anesthesia and managed with a laryngeal mask.

Findings

Subglottic stenosis was detected during tracheal intubation in a patient with no prior symptoms.

A laryngeal mask was successfully used to manage the airway when intubation failed.

Asymptomatic SGS can pose unexpected challenges during anesthesia induction.

Abstract

Subglottic stenosis (SGS) can be asymptomatic in cases with slow-growing granulomas. In this study, we report a case of SGS discovered during tracheal intubation for anesthesia induction. A 74-year-old woman was scheduled for surgery under general anesthesia for a left humeral fracture. Resistance was observed when the tracheal tube passed through the glottis, stopping the tube from advancing. We placed a laryngeal mask (LMA) to secure her airway and examined it using a bronchial fiber to detect circumferential stenosis of the subglottis due to granulation. The airway was secured using an LMA instead of intubation, and the patient was successfully managed under anesthesia. Asymptomatic SGS is difficult to detect preoperatively, and anesthesiologists may encounter unexpected intubation issues. LMA is an important tool for an effective strategy to manage intubation difficulties.

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