The Successful Management of Severe Subglottic Stenosis Under Jet Ventilation

A previously healthy thirty year-old woman presented with respiratory distress secondary to severe subglottic stenosis at twenty-seven weeks gestation. We report her presentation and diagnosis. Next, we describe a means of intra-operative management with balloon dilation and lasering using a total intravenous anesthetic and two methods of sub-glottic jet ventilation. Critical for the success of this operation and all shared airway cases is thoughtful pre-operative planning and intra-operative communication between the surgical and anesthesia teams. Lastly, we address barotraumas, one of the complications of using jet ventilation and recommend considering chest ultrasounds for diagnosis of pneumothorax.