Abstract
Background. Central airway obstruction (CAO) is a fatal state that must be resolved promptly. Case. The patient was a 89-year-old man who could not move on his own due to respiratory discomfort. He was brought to our hospital in an ambulance. The initial diagnosis was an asthmatic crisis and he was treated for asthma. However, his respiratory condition did not improve. Endotracheal intubation was attempted but was difficult, and so emergency tracheostomy was required. During tracheostomy, cardiopulmonary arrest occurred. He was resuscitated by cardiopulmonary resuscitation and tracheostomy was completed. After tracheostomy, bronchoscopy revealed a tumor which had become incarcerated in the left main bronchus. The tumor was large and difficult to remove. We grasped the tumor with a basket forceps and removed it along with the tracheostomy tube. The patient's subsequent clinical course has been good. The diagnosis was laryngeal cancer, cT2N0M0 Stage II. We decided on radiotherapy in accordance with the patient's condition and in consideration of his advanced age. He completed radiotherapy (63 Gy/28 Fr). At present, the patient visits the outpatient clinic regularly for follow-up. There have been no signs of recurrence. Conclusion. A dropped laryngeal tumor caused by endotracheal intubation can induce cardiopulmonary arrest due to CAO. When the presence of a tumor in the upper respiratory tract is suspected, the procedure to secure the airway must be carefully performed.
