Anticipated Difficult Airway and Thoracic Surgery: A Conflictive Marriage

Abstract

We describe the airway management in a 59-year-old female with a history of partial supraglottic laryngectomy and foreign body sensation, scheduled for a left upper lobectomy. Her medical history included current smoker, obesity (Body Mass Index of 31), anxiety disorder, and agoraphobia treated with venlafaxine, as well as a history of transoral laser epiglottectomy for squamous cell carcinoma (T1N0) performed four years ago. A follow-up computed tomography (CT) revealed a 10 mm pulmonary nodule in the apico-posterior segment of the left upper lobe, with no metastases found in positron emission tomography (PET). Consequently, video-assisted thoracic surgery (VATS) left upper lobectomy with lymph node sampling was indicated.