Intraoperative Innovation Leading to a Modified Endotracheal Tube: A Case Report of Endobronchial Intubation of Total Laryngectomy Stoma

Abstract

The post-total laryngectomy airway poses perioperative challenges to anesthesia management. While endobronchial intubation is a cited complication, a low-lying stoma may increase this risk. Furthermore, the stoma’s proximity to a median sternotomy increases surgical and airway management complexity. This report highlights a case of endobronchial intubation in a patient with a low-lying stoma who presented for coronary artery bypass graft. With a stoma at the upper border of the sternum, intraoperative innovation was required to prevent endobronchial intubation while remaining out of the surgical field. This innovation may be useful in urgent surgical situations.

Keywords

• coronary artery bypass graft
• low-lying stoma
• median sternotomy
• modified endotracheal tube
• total laryngectomy