One-lung ventilation via tracheostomy and left endobronchial microlaryngeal tube

A novel application of the Hyperflex™ tracheostomy tube for lung isolation in a patient with airway stoma after laryngectomy

In patients who have undergone laryngectomy followed by permanent tracheostomy, managing the airway for one-lung ventilation during lung surgery may present a challenge for anaesthetists. This case report discusses a 45-year-old man with a permanent tracheostomy after a laryngectomy performed for laryngeal carcinoma 5 years ago. He was scheduled to undergo excision of a right bronchial mass for which one-lung ventilation was required. An adjustable Flange Hyperflex™ Tracheostomy tube (Bivona® Silicone Tracheostomy tube, Smiths Medical ASD, Inc., Gary, Indiana, USA) was used for this purpose and the tube was guided into the left main bronchus with a bronchoscope. Appropriate lung isolation was achieved using this technique, and there were no airway-related complications during or after the surgery. This case report shows that a Hyperflex™ tracheostomy tube can be successfully utilised in challenging airway scenarios in patients with a tracheostomy, where other options may not be feasible.