Laryngeal ball valve tumor GVL and Shikani

Presented by Dr. James DuCanto, Aurora St. Luke's Medical Center.
 

The presented video illustrates a careful, stepwise approach to the airway management of a patient with the partially obstructed airway.

A specialized, four channel digital video recorder (DVR) was used to handle the video feeds from the various endoscopes utilized during the patient's care. The DVR simplified the display of video endoscopy information, as well as the recording of the procedure with prior patient consent. Post procedure editing allowed endoscopy views to be imbedded in the side-camera image.

Case presentation:

A 79 y.o. male with mobile, fungating T2N0 squamous cell carcinoma of the left vocal cord involving perilaryngeal tissues, presented with progressive shortness of breath and diminished exercise tolerance. The patient had minimal inspiratory stridor, as he was able to self-regulate the rate and depth of breathing to reduce the degree of dynamic airway obstruction. There was no tracheal extension of the tumor, and the patient’s past medical history was otherwise non-significant.

On presentation the patient was a vibrant and pleasant elderly male, who cooperated with the preoperative interview and physical exam. Examination of the patient’s airway revealed a Mallampati class 2 airway, thyromental distance of 7.5 cm, and a head-and-neck range of motion of approximately 90 degrees. Neck was without visible distortion, no perceptible masses were palpated on physical examination, and the cricothyroid membrane was easily identifiable....
 

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