Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Advanced glottic carcinoma presents complex airway challenges during total laryngectomy, requiring a balance between maintaining ventilation and ensuring unobstructed surgical access. Airway devices such as the Oxford tube and flexometallic tube offer distinct advantages and limitations. We report the case of a 64‐year‐old hypothyroid female with moderately differentiated squamous cell carcinoma of the glottis and thyroid cartilage erosion. She underwent total laryngectomy, partial pharyngectomy, PMMC flap reconstruction, bilateral neck node sampling, and primary tracheoesophageal puncture (TEP) device insertion. A flexometallic tube was chosen for airway management through the pre‐existing tracheostomy stoma, enabling repeated intraoperative repositioning without kinking and maintaining secure ventilation throughout surgery. Flexometallic tubes provide flexibility, kink resistance, and ease of repositioning in complex head‐and‐neck surgeries. However, documented risks include spiral dislodgement, cuff leaks undetectable by standard checks, dynamic obstruction, and accidental extubation due to elastic recoil, particularly in reused tubes. A detailed device inspection and vigilant intraoperative monitoring are essential. In selected cases of complex laryngectomy, a flexometallic tube-when meticulously inspected and correctly positioned‐can function as an effective “armoured rescue” airway device.
How to cite this article:
S. Shanthi, K. Manju and K.S. Senthil. Armoured Rescue: Flexometallic Endotracheal Tube Secures the Airway in Total Laryngectomy for Glottic Carcinoma with Cartilage Erosion.
DOI: https://doi.org/10.36478/makrjms.2024.10.692.695
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.10.692.695