Sažetak sa skupa
Accidental removal of glottic carcinoma during direct laryngomicroscopy and follow-up bronchoscopy: a case report
Andro Tarle
; KBC Sestre milosrdnice, Zagreb, Hrvatska
Mateo Čukman
; KBC Sestre milosrdnice, Zagreb, Hrvatska
Boris Ivkić
; KBC Sestre milosrdnice, Zagreb, Hrvatska
Andro Košec
; KBC Sestre milosrdnice, Zagreb, Hrvatska
Siniša Stevanović
; KBC Sestre milosrdnice, Zagreb, Hrvatska
Sažetak
Introduction: Endoscopic surgery for glottic carcinoma is a standardized and safe procedure. However, in
certain circumstances and localizations of the lesion, airway management prior and during surgery may pose
a significant challenge. Accidental removal of glottic carcinoma during intubation is a very rare occurrence
and poses an interesting diagnostic and therapeutic problem. Case report A patient with suspect T1a glottic
laryngeal carcinoma was referred to our department because of hoarseness that had been going on for the past
month. She had no other complaints. The patient was healthy, a non-smoker and had no other risk factors. The
examination revealed a well-perfused lesion in the front two thirds of the left vocal cord. Direct
laryngomicroscopy under general anesthesia was indicated. During intubation, the lesion was accidentally torn
off with the Storz endoscope. During direct laryngoscopy, no lesion was observed, a limited excision of the
tumor base was performed. The tissue was sent for urgent PH analysis and mild atypia was observed by the
pathologist. Subsequently, bronchoscopy was performed and the aspirate was sent for PH analysis, which
revealed that the aspirate contained carcinoma in situ. The patient was followed-up regularly. During the first
6 months postoperatively, the patient was monitored on a monthly basis. Her voice was fine, and she had no
other complaints. One year after the surgery, the patient has been checked-up every 2 months and is still
without any complaints. Conclusion: In general, direct laryngomicroscopy is a safe operative method with a
high success rate. However, considering the localization and the fact that it is performed under general
anesthesia, various problems can occur. This case shows that, despite the difficulties that may occur during the
surgery, a correct decision at a moment may lead to the desired result. In addition to the patient's survival,
which is the most important aim, the quality of life can also be preserved with the right therapeutic method.
This was the case with our patient, who has not had any complaints so far, nor has she shown any signs of
recurrence of the disease.
Ključne riječi
vocal cord; hoarseness; tumor; laryngomicroscopy; intubation
Hrčak ID:
308125
URI
Datum izdavanja:
19.9.2023.
Posjeta: 139 *