Extracorporeal Membrane Oxygenation (ECMO)-Assisted Tracheostomy in a Patient with a "Woody Neck" Due to Radiation Therapy and Complicated by Bilateral Internal Jugular Vein Occlusion: A Case Report.

体外膜肺氧合 （ ECMO ） 辅助气管造口术治疗因放射治疗而合并双侧颈内静脉阻塞的 “伍迪颈部 ” 患者 ： 一例病例报告。

• 发表时间: 2024
• 来源期刊: Int Med Case Rep J
• DOI: 10.2147/IMCRJ.S465848
• PMID: 39131234
• 文章类型: Case Reports
• 作者列表: Bales T,Hamid A,Fadumiye CO

关键词: case report; extracorporeal membrane oxygenation; head and neck cancer; neck fibrosis; “woody neck”

Abstract

Radiation for head and neck cancer (HNC) can lead to neck fibrosis, commonly known as \"woody neck\", limiting neck mobility. We report the case of a 46-year-old male with a history of tonsillar squamous cell carcinoma, with a \"woody neck\" following multiple radiation treatments. Facial swelling and impending airway loss prompted emergent intubation. Despite nasotracheal tube placement, bilateral internal jugular vein occlusion led to a difficult tracheostomy. An airway exchange catheter (AEC) facilitated multiple attempts at tracheal cannulation, but due to challenging anatomy, prolonged nasotracheal intubation was maintained. Tracheostomy was attempted again with extracorporeal membrane oxygenation (ECMO) support, which resulted in successful tracheal cannulation.

摘要

头颈癌（HNC）的辐射可导致颈部纤维化，俗称“木质脖子”，限制颈部活动。我们报告了一名46岁的男性，有扁桃体鳞状细胞癌的病史，经过多次放射治疗后的“木质脖子”。面部肿胀和即将发生的气道丧失促使紧急插管。尽管放置了鼻气管导管，双侧颈内静脉阻塞导致困难的气管造口术。气道交换导管（AEC）促进了气管插管的多次尝试，但是由于具有挑战性的解剖学，维持延长的经鼻气管插管。在体外膜氧合（ECMO）支持下再次尝试气管造口术，导致成功的气管插管。