[Usefulness of ultrasound pre-scanning for cricothyroid membrane puncture in a patient with rupture of a pseudoaneurysm].
A 63-year-old man with von Recklinghausen disease was transported to the emergency department for swelling and pain of his right neck. Chest X-ray and computed tomography scan showed displacement of the trachea to the left by a tumor mass. Urgent airway management was required and fiberoptic intubation in awake condition was planned. First we pre-scanned cricothyroid membrane by ultrasound in a case of emergency. Regardless of several trials, his trachea could not be secured by fiberscope because of narrow pharyngeal space. Suddenly, his consciousness level and Sp(O2) went down, therefore surgical airway was required. Due to pre-scanning, emergency cricothyroid membrane puncture could be performed immediately without any complications. We recommend ultrasound pre-scanning for cricothyroid membrane puncture in a patient with suspected tracheal displacement.