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Year : 2022  |  Volume : 5  |  Issue : 2  |  Page : 77-80

Airway management of a giant thoracic ganglioneuroma causing airway obstruction in a 3-year-old child

1 Department of Anaesthesia and Critical Care, Army Hospital (Research and Referral), New Delhi, India
2 Department of Cardiothoracic Surgery, Army Hospital (Research and Referral), New Delhi, India

Correspondence Address:
Dr. Simrandeep Singh
Department of Anaesthesia and Critical Care, Army Hospital (Research and Referral), Delhi Cantonment, New Delhi - 110 010
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/arwy.arwy_7_22

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Large tumours occupying one half of the thoracic cavity are rare and may cause life-threatening complications by compression or invasion of vital structures that results in cardiovascular and/or respiratory insufficiency. In-depth preoperative planning is necessary after assessment of perioperative risk of hemithoracic masses. By providing lung isolation, one-lung ventilation technique provides improved surgical conditions compared to conventional dual-lung ventilation for thoracic surgery. As double-lumen tubes are not available for smaller children, balloon-tipped bronchial blockers remain the technique of choice, especially under the age of 6 years. Huge intrathoracic masses in small children with radiological and clinical findings suggesting airway compression are high risk for airway complications. Fibreoptic bronchoscope-guided intubation should be preferred in view of tracheobronchial compression by the mass and placement of an endobronchial blocker helps in one-lung ventilation in small children. The management of these tumours is challenging and should be performed only in specialised centres.

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