Abstract
A 4-year-old boy underwent tonsillectomy for obstructive sleep apnea syndrome. No sedatives were administered before operation. After awake intubation anesthesia was induced and maintained with halothane 0.5%, 67% nitrous oxide in oxgen and d-tubocurarine. Soon after extubation, upper airway obstruction occurred and the trachea was intubated again.
Then tracheostomy was performed under general anesthesia. There was a dramatic improvement of clinical symptoms shortly after tracheostomy.
However, when the tracheal stoma was closed, episodes of apnea due to upper airway obstruction were immediately seen even when he was fully alert in the daytime. Period of closure of the stoma became longer week by week and finally it could be closed all day long three months after operation. He has been followed for 18 months after surgery and the tracheal stoma was operatively closed.
