Tubeless Airway Strategy Using THRIVE And TCI For Subglottic Stenosis: Case Report

Abstract

Granulomatosis with polyangiitis (GPA) is a systemic vasculitis that can cause subglottic stenosis (SGS), posing significant challenges in airway management. We present a case of a 19-year-old male with GPA and Grade 2 SGS who underwent successful balloon dilatation under general anaesthesia using Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) and Target-Controlled Infusion (TCI) of Propofol. THRIVE enabled uninterrupted apnoeic oxygenation and improved surgical access, while TCI ensured stable anaesthetic depth. The procedure was completed uneventfully in 25 minutes with no desaturation. This case highlights THRIVE-TCI as an effective alternative in managing complex shared-airway  surgeries.