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The usefulness of the videolaryngoscope for the diagnosis of an unknown epiglottic tumor

Benítez-Jiménez, Mercedes; Rodríguez-Navarro, María Ángeles; González-Pérez, Petra; Díaz-Alejo, Clara; Alcaraz-Martínez, Ana Belén; Sánchez-Ródenas, Lorenzo

Colombian Journal of Anesthesiology: January-March 2019 - Volume 47 - Issue 1 - p 69–70
doi: 10.1097/CJ9.0000000000000089
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Spanish Version

Anesthesia and Pain Department, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain.

Correspondence: Anesthesia and Pain Department, Hospital General Universitario J.M. Morales Meseguer, Calle Marqués de los Vélez, Murcia 30009, Spain. E-mail: Marodrigueznavarro@yahoo.es

How to cite this article: Benítez-Jiménez M, Rodríguez-Navarro MA, González-Pérez P, Díaz-Alejo C, Alcaraz-Martínez AB, Sánchez-Ródenas L. The usefulness of the videolaryngoscope for the diagnosis of an unknown epiglottic tumor. Rev Colomb Anestesiol. 2018;00:000–000.

Read the Spanish version of this article at: http://links.lww.com/RCA/A836.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.www.revcolanest.com.co).

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

The contribution of video-laryngoscopy to improving the process of orotracheal intubation has been shown if various publications emphasizing an improved and better quality vision of the mouth and the larynx; it is extremely valuable for teaching purposes and is part of the algorithm for the intubation of a predicted difficult airway.1,2

This article discusses the case of a 54-year-old patient admitted to the emergency OR for surgery of an ascending colon neoplasm and secondary intestinal obstruction. The patient has a history of smoking 10 packs/year, criteria consistent with chronic bronchial disease, and hepatitis C.

In the light of the risk of bronchoaspiration, induction, and rapid sequence intubation were conducted uneventfully. During the laryngoscopy with a Macintosh, an epiglottic mass was identified. Following the intubation and the tracheal pneumo-tamponade, we conducted a second laryngoscopy using a video laryngoscope Glidescope Titanium (Verathon Medical Bothell, WA, USA), which clearly revealed an epiglottic tumor.

After obtaining the consent of a family member, the planned hemicolectomy was conducted, in addition to a resection through laryngeal microsurgery and a biopsy of the epiglottic tumor identified (0.75 cm) (Fig. 1A and B).

Figure 1

Figure 1

Several papers argue that the total time elapsed during intubation and isolation of the airway is longer with the use of the video-laryngoscope versus the routine laryngoscopy, when the operator is still in the learning curve2; this is why the laryngoscope was used.

The use of video-laryngoscopes—Glidescope, King Vision—initially designed to facilitate orotracheal intubation, is very frequent in the algorithm for managing a difficult airway,3 in addition to a very exciting application in oropharyngeal surgery.4 Furthermore, we find that the device allows for an easy and minimally invasive exploration as compared against laryngoscopy using a rigid laryngoscope, as illustrated in our case in which the problem was solved in the same surgical-anesthetic procedure.

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Ethical disclosures

Protection of persons and animals: The authors claim that no experiments in humans or animals were conducted for this research.

Confidentiality of the information: The authors declare that they followed the protocols of their workplace with regard to disclosure of patient data.

Right to privacy and informed consent: The authors declare that this article does not disclose any patient information.

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Funding

Author's own resources.

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Conflicts of interest

Authors declare no conflicts of interest implied in the writing of this manuscript.

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References

1. Griesdale DE, Liu D, McKinney J, et al Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anaesth 2012;59:41–52.
2. Lewis SR, Butler AR, Parker J, et al Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev 2016;11:CD011136.
3. España Fuente L, De la Rica Fernández P, González González JL. Use of King Vision® videolaryngoscope in an unanticipated difficult airway in an adult patient with giant vallecular cyst, a case report. Rev Esp Reanim 2017;64:61–67.
4. Bruno E, Dauri M, Mauramati S, et al Utility of glidescope videolaryngoscopy in surgical procedures involving the larynx. Acta Otorhinolaryngol Ital 2015;35:45–48.
Keywords:

Airway Management; Laryngoscopy; Epiglottis; Laryngeal Neoplasms; Intubation; Manejo de la vía aérea; Laringoscopía; Epiglotis; Neoplasias Laríngeas; Intubación

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