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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With A Carcinoid In Left Lower Lobe. Having Pain In Suprasternal Notch. Suggestions?

Hi. Was diagnosed w/ a carcinoid in left lower lobe. (i hav a very small mouth) Drs tried to do a lobectomy but were unable to intubate me becuase they felt resistence just past my vocal chords. Any idea of what is causing this? They said its rare. I also have pain (like a knife) @ my suprasternal notch . Any ideas? Thanx
Mon, 26 Aug 2013
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Pain Medicine & Palliative Care Specialist 's  Response
Hi,
Intubation involves passing a breathing tube down the windpipe (trachea). The tube needs to pass between the vocal cords. If there is a narrowing at any point of the windpipe then placing the breathing tube will be difficult or impossible.
There are many causes of resistance to the passage of the tube. I expect the anesthetist tried smaller sizes of tube but to no avail. The causes include swelling of the trachea, cysts, enlarged lymph nodes. It would not be possible to comment any further on this without further details.
As for your pain at your suprasternal notch, this may be due to the trauma of the attempts of passing the tube. The lining of the trachea will have been traumatised and may take a few days to recover.
Regards,
Dr K A Pottinger,
MBChB FRCA
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Diagnosed With A Carcinoid In Left Lower Lobe. Having Pain In Suprasternal Notch. Suggestions?

Hi, Intubation involves passing a breathing tube down the windpipe (trachea). The tube needs to pass between the vocal cords. If there is a narrowing at any point of the windpipe then placing the breathing tube will be difficult or impossible. There are many causes of resistance to the passage of the tube. I expect the anesthetist tried smaller sizes of tube but to no avail. The causes include swelling of the trachea, cysts, enlarged lymph nodes. It would not be possible to comment any further on this without further details. As for your pain at your suprasternal notch, this may be due to the trauma of the attempts of passing the tube. The lining of the trachea will have been traumatised and may take a few days to recover. Regards, Dr K A Pottinger, MBChB FRCA