Tracheostomy Tube Ignition During Microlaryngeal Surgery Using Diode Laser: A Case Report

Ignition of the tracheal tube during laser microlaryngeal surgery under general anesthesia is an uncommon complication with potentially serious consequences. We present here a case of a patient with glottic stenosis following endotracheal intubation, who experienced this potentially catastrophic combustion during endoscopic arytenoidectomy, using a diode laser under general anesthesia via 60% FiO2, with an airway fire occurring at the tracheostomy tube and causing tubal damage and obstruction. The anesthetic connecting tube was immediately disconnected and the tracheostomy tube replaced. No adverse consequences to this patient's upper airway were noted during follow-up visits. Higher oxygen concentrations, the presence of combustibles, and the narrowness of the surgical field during endolaryngeal diode laser surgery are risk factors for airway fires.