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GENERAL ARTICLES

A Severe Complication After Laser-Induced Damage to a Transtracheal Catheter During Endoscopic Laryngeal Microsurgery

Bettina Leemann, MD^*, Thomas Heidegger, MD^*, Rudolf Grossenbacher, MD, Thomas Schnider, MD^*, and Hans J. Gerig, MD^*

Departments of *Anesthesiology and Ear, Nose, Throat, Head, and Neck Surgery, St. Gallen Cantonal Hospital, St. Gallen, Switzerland

Address correspondence and reprint requests to Bettina Leemann, MD, Department of Anesthesiology, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland. Address e-mail to bettina.leemann{at}kssg.ch

Subcutaneous emphysema and pneumothorax is a rare and severe complication of percutaneous transtracheal jet ventilation, usually caused by obstruction of the upper airway or displacement of the tracheal catheter. Nevertheless, it is our preferred technique for endoscopic laryngeal laser surgery. We report a patient with acute subcutaneous emphysema and pneumothorax during laser surgery, caused by unobserved laser damage and discuss the associated risk factors.

IMPLICATIONS: The percutaneous transtracheal jet ventilation for elective laryngeal laser surgery reduces the risk of airway fires and gives a free endoscopic operative field. This case report suggests that, even when using a teflon catheter, laser-induced damage with severe complications might occur.

This article has been cited by other articles:

				M. B. Sosis, B. Leemann, T. Heidegger, R. Grossenbacher, T. Schnider, and H. J. Gerig Should CO2 Laser Jet Ventilation Be Abandoned? * Response Anesth. Analg., December 1, 2004; 99(6): 1882 - 1882. [Full Text] [PDF]