Extracorporeal Membrane Oxygenation (ECMO)-Assisted Tracheostomy in a Patient with a "Woody Neck" Due to Radiation Therapy and Complicated by Bilateral Internal Jugular Vein Occlusion: A Case Report. Int Med Case Rep J 2024;17:739-744
Date
08/12/2024Pubmed ID
39131234Pubmed Central ID
PMC11316490DOI
10.2147/IMCRJ.S465848Scopus ID
2-s2.0-85203078095 (requires institutional sign-in at Scopus site)Abstract
Radiation for head and neck cancer (HNC) can lead to neck fibrosis, commonly known as "woody neck", limiting neck mobility. We report the case of a 46-year-old male with a history of tonsillar squamous cell carcinoma, with a "woody neck" following multiple radiation treatments. Facial swelling and impending airway loss prompted emergent intubation. Despite nasotracheal tube placement, bilateral internal jugular vein occlusion led to a difficult tracheostomy. An airway exchange catheter (AEC) facilitated multiple attempts at tracheal cannulation, but due to challenging anatomy, prolonged nasotracheal intubation was maintained. Tracheostomy was attempted again with extracorporeal membrane oxygenation (ECMO) support, which resulted in successful tracheal cannulation.
Author List
Bales T, Hamid A, Fadumiye COAuthors
Travis R. Bales MD Instructor in the Anesthesiology department at Medical College of WisconsinChristopher Fadumiye MD Assistant Professor in the Anesthesiology department at Medical College of Wisconsin
