I got a good response to a missive sent out via email, so we are trying this again. This is what I sent previously:
Numerous people responded correctly. It is indeed a papilloma, which was causing variable obstruction as it swung back and forth through the vocal cords on it’s pedicle. It was managed by videolaryngoscopic intubation with a microlaryngoscopy tube (MLT) followed by surgical debulking by the ENT. Here is a nice simple summary of MLTs and other special ETTs used in ENT surgery, although they erroneously attribute the acronym RAE. Click here for more about ETTS and to see the correct source.
Pic for this week:
This is a bronchoscopic view from the mid-tracheal level in an infant. Can you tell:
A) What is going on here?
B) Is there a classification system for this pathology, and can you fit this case into it?
C) What is the main challenge and advised technique for dealing with this airway?
Let me know if this is interesting/useful 😉