Airway Management of Patient With Mounier–Kuhn Syndrome: A Case Report

Mounier-Kuhn syndrome (MKS) is a rare disorder characterised by tracheobronchomegaly, which poses significant anaesthetic challenges due to air leaks during mechanical ventilation. We report a 65-year-old male with previously undiagnosed MKS who underwent cardiac surgery. Following intubation with an 8-mm endotracheal tube (ETT), a persistent air leak resulted in inadequate ventilation despite tube repositioning and upsizing to a 9-mm ETT. Preoperative chest imaging revealed significant tracheal dilation. To achieve adequate ventilation, we implemented a modified technique: advancing the ETT into the right main bronchus, then retracting until bilateral breath sounds were audible, supplemented by gauze packing to reinforce the seal. This case underscores the importance of preoperative recognition of MKS to anticipate ventilation difficulties. The described technique, adapted from tracheoesophageal fistula management, effectively resolved the air leaks complication.