Unusual Airway Obstruction during General Anesthesia following Endotracheal Tube Cuff Herniation; A Case Report

Airway management is always of great concern for anesthesiologists especially in the prone position. Utilizing an Armored endotracheal tube is considered to be safe in such patients.

Cases Report:

In this current case, we introduce a patient undergoing a wake-up test during spinal surgery who suffered from hypoventilation at the end of surgery. His condition improved only after extubation. After extubation, we confronted a herniated cuff that was not deflated, although we tried twice. We concluded that the patient's respiratory effort against obstructed airway produced a negative pressure, which made the cuff herniated, resulting in airway obstruction. Moreover, the patient biting the tube during the wake-up test damaged the tube and cuff deflation pathway.

It is important to consider cuff herniation as a cause of obstruction when other possible etiologies are ruled out.