Challenges In the Management of Acute Airway Obstruction in A Toddler with Cervical Macrocystic Lymphatic Malformation (Cystic Hygroma): A Case Report

Syeda Taajwar Zaineb, Muniba Mehmood, Javeria Alvi

Abstract

ABSTRACT

We report an 18-months-old female toddler with macrocystic lymphatic malformation (cystic hygroma) of cervical region who presented with severe airway compromise. Considering the increase in the size of swelling and its effect airway on urgent intervention was required. High-flow supplemental oxygen was provided by a non-rebreathing mask. However, severe respiratory acidosis and hypoxemia persisted. As imminent respiratory failure was feared due to airway obstruction a need to secure definitive airway was identified. Attempts at endotracheal intubation failed. Decision was taken to perform needle cricothyroidotomy but anatomical landmarks could not be appreciated. Tracheostomy was then performed which was a challenge as trachea was difficult to identify. This case report highlights the steps taken in the management of compromised airway for general information of readers.

Key words

Macrocystic lymphatic malformation, Cystic hygroma, Tracheostomy, Respiratory failure, Child.