A Case of Difficult Airway Management after Endoscopic Trans-sphenoidal Surgery Complicated with Obstructive Sleep Apnea Syndrome

Abstract

Endoscopic trans-sphenoidal surgery（eTSS）mandates mouth breathing postoperatively because gauze packing of bilateral nasal cavity is necessary for hemostasis. We report a female patient in her fifties with obstructive sleep apnea（OSA）treated with nasal continuous positive airway pressure（nCPAP）who underwent eTSS. Her height was 160 cm, body weight was 97 kg, and body mass index was 38 kg/m². After extubation in the operating room, she was re-intubated in a CT suit because of glossoptosis due to cerebral hemorrhage. Thereafter, the length of her hospital stay was prolonged due to hypoxic-ischemic encephalopathy. The risk of airway obstruction is high after eTSS. Nasal airway insertion may be effective for postoperative management of OSA patients treated with nCPAP who underwent eTSS.