Abstract
Background: Airway management is always of great concern for anesthesiologists especially in the prone position. Utilizing an Armored endotracheal tube is considered to be safe in such patients.
Cases Report: In this current case, we introduce a patient undergoing a wake-up test during spinal surgery who suffered from hypoventilation at the end of surgery. His condition improved only after extubation. After extubation, we confronted a herniated cuff that was not deflated, although we tried twice. We concluded that the patient's respiratory effort against obstructed airway produced a negative pressure, which made the cuff herniated, resulting in airway obstruction. Moreover, the patient biting the tube during the wake-up test damaged the tube and cuff deflation pathway.
Conclusion: It is important to consider cuff herniation as a cause of obstruction when other possible etiologies are ruled out