Laryngofissure in comorbid patient under ultrasound-guided regional anesthesia of the neck

Abstract

Abstract Background Major neck surgery is done typically under general anesthesia (GA). The neural blocks of the neck include blocking of the cervical plexus, superior laryngeal nerve, trans-laryngeal, block of the glossopharyngeal nerve, and local anesthetic infiltration. In patients with a high risk of GA, including those with pulmonary dysfunction, and prior myocardial ischemia or infarction, regional anesthesia is mainly indicated. Case presentation We record a case of a comorbid geriatric patient with dysphonia and left glottic mass that was diagnosed as squamous cell papilloma by transoral biopsy using curved biopsy forceps under local spray anesthesia, and after 6 months, this patient developed stridor for which tracheostomy, laryngofissure, and left cordectomy were then performed solely under neck blocks. Surgery was performed while the patient remained pain-free and stable without any morbidity throughout the operation. Conclusions In high-risk patients and low-resource health systems, regional anesthesia in neck surgery can be a reasonable and cheap alternate to general anesthetics.