Laryngeal amyloidosis: Inadvertent risk for Endotracheal intubation

Abstract

Objective: To describe a rare case of localized laryngeal amyloidosis that presented an inadvertent risk for endotracheal intubation. Result: This is the case of a 58-year-old female who presented with hoarseness and inspiratory stridor of several years duration. Laryngoscopic examination revealed a large left supraglottic mass arising from the left aryepiglottic fold and obscuring the true vocal cords. Computed tomography revealed a hypodense mass located in the left submucosal space at the supraglottic and glotticlevel. Intraoperative assessment by the anesthesia team for a direct laryngeal biopsy and tracheostomy procedure revealed difficult airway. Subsequently, bilateral superior laryngeal nerve block was done followed by successful fiberoptic intubation using tube number 6 while the patient is awake and with no sedation. Conclusion: Securing the airway in patients with laryngeal amyloidosis is challenging and mandates proper management strategy by anesthesiologists. © 2018, American University of Beirut. All rights reserved.