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CASE REPORT
Year : 2021  |  Volume : 16  |  Issue : 2  |  Page : 381-383

Endotracheal tube obstruction experienced during an anterior cervical discectomy and fusion


1 Department of Neurosurgery; Spine Center, Aichi Medical University, Nagakute, Japan
2 Spine Center, Aichi Medical University, Nagakute, Japan
3 Department of Neurosurgery, Aichi Medical University, Nagakute, Japan
4 Department of Anesthesiology, Aichi Medical University, Nagakute, Japan
5 Department of Anesthesiology, Konan Kosei Hospital, Konan, Aichi, Japan

Correspondence Address:
Dr. Masahiro Aoyama
Department of Neurosurgery, Aichi Medical University, 1-1 Yazakokrimata, Nagakute, Aichi 480-1195
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_258_20

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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.


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