Mounier-Kuhn Syndrome: Anesthetic Experience

Mounier Kuhn syndrome, or congenital tracheobronchomegaly, is an under diagnosed clinical entity with peculiar anatomical and physiological features making anesthetic care challenging. A 58-year-old chronic smoker with history of recurrent pneumonia and bronchiectasis presented for septoplasty. Thor...

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Main Authors: Deepu Sasikumaran Ushakumari, Navneet Grewal, Michael Green
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2012/674918
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author Deepu Sasikumaran Ushakumari
Navneet Grewal
Michael Green
author_facet Deepu Sasikumaran Ushakumari
Navneet Grewal
Michael Green
author_sort Deepu Sasikumaran Ushakumari
collection DOAJ
description Mounier Kuhn syndrome, or congenital tracheobronchomegaly, is an under diagnosed clinical entity with peculiar anatomical and physiological features making anesthetic care challenging. A 58-year-old chronic smoker with history of recurrent pneumonia and bronchiectasis presented for septoplasty. Thoracic imaging revealed a dilated trachea and main bronchi, tracheal and bronchial diverticuli, and chronic bronchiectasis with mediastinal lymphadenopathy. An 8.5 cuffed endotracheal tube (ETT) proved too big for his glottic aperture. An 8.0 cuffed ETT with wet gauze packing yielding an adequate seal. Postoperative continuous positive airway pressure to prevent airway collapse followed awake extubation. Anesthetic concerns include grossly enlarged and weakened airways, inefficient cough mechanisms, presence of tracheal diverticuli, and post operative tracheal collapse. Anesthetic planning includes management of endotracheal cuff size. Small size yields air leak and ineffective ventilation. Large size may lead to mucosal damage. Tube dislodgement, copious secretions, chance of expiratory collapse due to the abnormally dilated and thin airways, and post operative monitoring all must be considered.
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spelling doaj-art-cf01f145f79c4f028b88a07c2a91b42d2025-08-20T02:19:30ZengWileyCase Reports in Anesthesiology2090-63822090-63902012-01-01201210.1155/2012/674918674918Mounier-Kuhn Syndrome: Anesthetic ExperienceDeepu Sasikumaran Ushakumari0Navneet Grewal1Michael Green2Drexel University College of Medicine and Hahnemann University Hospital, Philadelphia, PA 19102, USADrexel University College of Medicine and Hahnemann University Hospital, Philadelphia, PA 19102, USADepartment of Anesthesiology, Drexel University College of Medicine and Hahnemann University Hospital, New College Building, Room 7502, Philadelphia, PA 19102, USAMounier Kuhn syndrome, or congenital tracheobronchomegaly, is an under diagnosed clinical entity with peculiar anatomical and physiological features making anesthetic care challenging. A 58-year-old chronic smoker with history of recurrent pneumonia and bronchiectasis presented for septoplasty. Thoracic imaging revealed a dilated trachea and main bronchi, tracheal and bronchial diverticuli, and chronic bronchiectasis with mediastinal lymphadenopathy. An 8.5 cuffed endotracheal tube (ETT) proved too big for his glottic aperture. An 8.0 cuffed ETT with wet gauze packing yielding an adequate seal. Postoperative continuous positive airway pressure to prevent airway collapse followed awake extubation. Anesthetic concerns include grossly enlarged and weakened airways, inefficient cough mechanisms, presence of tracheal diverticuli, and post operative tracheal collapse. Anesthetic planning includes management of endotracheal cuff size. Small size yields air leak and ineffective ventilation. Large size may lead to mucosal damage. Tube dislodgement, copious secretions, chance of expiratory collapse due to the abnormally dilated and thin airways, and post operative monitoring all must be considered.http://dx.doi.org/10.1155/2012/674918
spellingShingle Deepu Sasikumaran Ushakumari
Navneet Grewal
Michael Green
Mounier-Kuhn Syndrome: Anesthetic Experience
Case Reports in Anesthesiology
title Mounier-Kuhn Syndrome: Anesthetic Experience
title_full Mounier-Kuhn Syndrome: Anesthetic Experience
title_fullStr Mounier-Kuhn Syndrome: Anesthetic Experience
title_full_unstemmed Mounier-Kuhn Syndrome: Anesthetic Experience
title_short Mounier-Kuhn Syndrome: Anesthetic Experience
title_sort mounier kuhn syndrome anesthetic experience
url http://dx.doi.org/10.1155/2012/674918
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