PHARYNGEAL FLAP NECROSIS AS A CAUSE OF AIRWAY-OBSTRUCTION DURING INDUCTION OF ANESTHESIA

Anesthesiologists should approach the airway carefully in the patient with a diagnosis of head and neck carcinoma, particularly if the patie nt has had previous surgery and reconstruction. Patients with head and neck carcinoma may be difficult intubations due to altered anatomy fr om the tumor or fibrotic changes because of radiation therapy. Our pat ient had had pharyngectomy and reconstruction with a pectoralis major skin flap. The patient returned to the operating suite for wide-excisi on pharyngectomy and had acute airway obstruction after induction of g eneral anesthesia. The pectoralis flap had necrosed, pulling away from the pharyngeal wall and obstructing the patient's glottic opening.