Management of elective laryngectomy

Life-Threatening Laryngeal Emphysema After Video-Assisted Thoracoscopic Surgery

“…20,21 Fiberoptic intubation was discouraged because of concerns about technical difficulty; "cork in bottle" effect; and loss of airway secondary to bleeding, sedation, and topicalization. 5,19,20 More recently, awake video-laryngoscope intubation, 19 total intravenous spontaneous breathing anesthesia with high-flow nasal oxygen, 24 and intravenous induction with muscle relaxation 25 all have been advocated, with no strong consensus regarding the optimum approach.…”

“…Given the imminent risk of airway compromise and complete obstruction, the anesthesiologist and surgeon rapidly transferred the patient to the operating room with the intention of safely securing the airway before treatment of the subcutaneous emphysema. The patient was placed in the sitting position, with temporary high-flow humidified nasal oxygen, 5,6 while an airway strategy was determined and equipment and personnel were prepared.…”

Approach to the Difficult Airway in Laryngeal Cancer

“…Long-term complications of oncological treatments may ultimately result in a "frozen larynx," where the patient requires a tracheostomy and gastrostomy, or even ultimately a laryngectomy to prevent aspiration. National guidelines recommend that laryngectomy is performed in specialist centers, as complication rates are lower in departments that perform this procedure frequently [3].…”

Anaesthesia for head and neck cancer surgery

“…17 Laryngectomy A detailed review was published by Stevens et al in BJA Education (2017). 18 Extubation A systematic approach with upright positioning, full reversal of residual neuromuscular blocking drugs, and preoxygenation is essential before extubation. The diffficult airway society (DAS) extubation guidelines serve as a framework to identify 'lowrisk' or 'at-risk' extubation.…”