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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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| 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. |
| format | Article |
| id | doaj-art-cf01f145f79c4f028b88a07c2a91b42d |
| institution | OA Journals |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| 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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