Anesthetic management of a patient with relapsing polychondritis - A case report

An Swe Tso*, Ham See Chung, Chung Yuan Wu, Jihn Yih Li, Chian Lang Hong, Min Wen Yang, Ping Wing Lui

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

11 Scopus citations

Abstract

Relapsing polychondritis is a rare multisystem disorder of uncertain etiology. It is characterized by recurrent and progressive destruction of both elastic and hyaline cartilages as well as connective tissue. Respiratory tract involvement is associated with high mortality and morbidity. General anesthesia may be required in these patients for tracheostomy, bronchoscopy, nasal reconstruction, aortic valve replacement, and recent tracheobronchial stenting which they usually sustain. Tracheostomy was once the most likely surgical procedure in relapsing polychondritis. However, this procedure is only effective in patients with upper subglottic involvement. In cases of extensive tracheobronchial involvement, tracheostomy is ineffective because the distant tracheal collapse below the tracheostomy is still unresolved. We would like to report a case of relapsing polychondritis with tracheobronchial involvement, who underwent an emergent tracheostomy. Tracheostomy with continuous positive airway pressure (CPAP) effectively improved her airway collapse. Herein, we also discuss the anesthetic management after review of the current literature.

Original languageEnglish
Pages (from-to)189-194
Number of pages6
JournalMa zui xue za zhi = Anaesthesiologica Sinica
Volume39
Issue number4
StatePublished - 2001
Externally publishedYes

Keywords

  • Polychondritis, relapsing
  • Positive pressure respiration
  • Postoperative complication: Dynamic airway collapse

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