During anterior cervical discectomy and fusion (ACDF), endotracheal tube difficulties
are anticipated at the operative level but are unexpected elsewhere in the airway.
We report the case of a 66-year-old woman who underwent C4/C5 ACDF to treat adjacent
segment disease following a previous anterior cervical fixation surgery. Shortly after
her lower jaw was elevated and the fusion cage was inserted, a rise in airway pressure
was observed, indicating impaired breathing. Subsequent examination revealed a bent
endotracheal tube in the oral cavity as the cause of the respiratory impairment. During
anterior cervical surgery, elevating the lower jaw can cause the tongue root to press
against the endotracheal tube. Reinforced endotracheal tubes, with a spiral-wound
wire in the inner wall, would effectively prevent this issue. In the unlikely event
of impaired breathing during such an operation, the oral cavity should be inspected
for confirmation of an open airway.
Key-words:
Anterior cervical discectomy and fusion - endotracheal tube - reinforced endotracheal
tube
