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Brachytherapy of tongue carcinoma in a patient with difficult airway: anesthetic considerations

The practice of brachytherapy in unresectable tongue carcinoma is gaining popularity. However, this procedure poses specific anesthetic challenges, particularly challenges of airway sharing and a higher rate of difficult airway. We report a 74-year-old chronic smoker, chronic alcoholic with history...

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Detalles Bibliográficos
Autores principales: Ghaffar, Zainab Abdul, Chong, Soon Eu, Tan, Kok Leng, Appalanaido, Gokula Kumar, Musa, Muhamad Yusri, Hussin, Hasmah binti, Jusoh, Nurulhuda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335561/
https://www.ncbi.nlm.nih.gov/pubmed/30662482
http://dx.doi.org/10.5114/jcb.2018.79856
Descripción
Sumario:The practice of brachytherapy in unresectable tongue carcinoma is gaining popularity. However, this procedure poses specific anesthetic challenges, particularly challenges of airway sharing and a higher rate of difficult airway. We report a 74-year-old chronic smoker, chronic alcoholic with history of stroke, who had undergone brachytherapy for tongue carcinoma. Apart from a huge tongue tumor, he had an epiglottic mass but refused elective tracheostomy. This had led to a few critical states throughout the process of treatment, including a metabolic crisis due to thiamine deficiency and difficult airway crisis. To our best knowledge, there have been no reported case on a patient with vocal cord mass undergoing tongue brachytherapy. We hope sharing of this experience may aid the management of similar patients in future.