Anesthetic management of a patient with laryngeal amyloidosis

A 73-year-old woman who suffered from progressive hoarseness for 6 years an d dysphagia without pain for 1 year presented with a soft tissue deposition on the posterior region of the vocal cords and narrowing in the subglottic area. Biopsy of this soft tissue and histological examination revealed lar yngeal amyloidosis. A tracheostomy and partial removal of the amyloid were performed with general anesthesia. The airway was secured with a smaller di ameter endotracheal tube which was inserted atraumatically with Magill's fo rceps. The larynx is a rare site for amyloidosis. Laryngeal amyloidosis is fragile and hemorrhagic. Therefore, massive bleeding may occur during intub ation. Anesthetists should take care in intubating the tracheas of these pa tients and be aware of other systemic diseases in laryngeal amyloidosis. (C ) 1999 by Elsevier Science Inc.