RT Book, Section
A1 Panzarasa, Jade
A1 Wong, Michael J.
A2 Hung, Orlando R.
A2 Murphy, Michael F.
SR Print(0)
ID 1202477106
T1 Management of Extubation of a Patient with an “Impossible Airway” Following Cervical Spine Fusion
T2 Hung’s Management of the Difficult and Failed Airway, 4<sup>th</sup> Edition
YR 2024
FD 2024
PB McGraw Hill
PP New York, NY
SN 9781264278329
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1202477106
RD 2023/12/10
AB A  75-year-old  man  with  ankylosing  spondylitis  and  previous  C2–T12  spinal  fusion  presented  with  a  C4–C5  chance  fracture  after  a  fall  (Figure  31.1).  While  neurologically  intact,  this  unstable  fracture  required  emergency  fixation.  He  had  a  predicted  difficult  airway  due  to  severe  fixed  kyphosis  with  his  chin  approximating  his  chest  and  was  Mallampati  IV  on  inspection.  Awake  orotracheal  intubation  using  flexible  bronchoscope  was  performed  with  difficulty  due  to  marked  cervical  kyphosis  but  was  successful  after  several  attempts.  Spinal  stabilization  surgery  in  prone  position  was  uneventful.  Postoperatively,  he  was  transferred  to  the  intensive  care  unit  (ICU),  intubated  and  sedated,  to  permit  careful  extubation  planning.