Diffuse idiopathic skeletal hyperostosis (DISH) is associated with abnormal ossification of spinal and extraspinal appendages. Incidence of DISH is high in old age with predilection for males. Cervical hyperostosis can make intubation difficult in multiple ways. Here, we report a case of DISH bridging the cervical spine from C2 to C7 vertebrae managed using awake fiberoptic technique and a small-sized endotracheal tube.
Diagnosis of a pneumothorax in the immediate post-operative area can be difficult. Traditional gold-standard modalities may not be available or feasible to institute. Ultrasound (US) guidance allows the anesthesia provider a method of quickly detecting this potentially life-threatening complication especially when it's least expected. We encountered such a case when a 40 years male patient posted for video assisted thoracic surgery for drainage of empyema on left side of chest developed pneumothorax on right side post-operatively. Timely diagnosis with the help of US saved time and his life. We thus want to emphasize the importance of this simple but useful skill to the anesthesiologist.
Gorlin-Goltz syndrome is a rare autosomal-dominant syndrome related to mutation in “Patched” tumour suppressor gene on chromosome 9. Basocellular carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri are its major features, along with more than 100 minor features. Odontogenic cysts, notorious for recurrence, can make endotracheal intubation difficult, requiring modification of the standard intubation technique. We report such a case managed successfully by awake fibreoptic intubation. Direct laryngoscopy under anaesthesia later confirmed that it was a good decision.
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