Rare case of difficult intubation: lingual tonsillar hypertrophy : case report
We report a case of unanticipated difficult intubation due to lingual tonsillar hypertrophy. This is a case of a 45-year-old lady with hypertension undergoing Scarf Osteotomy and Wedge osteotomy right first metatarsal bone and soft tissue McBride procedure due to Bilateral hallux valgus stage 4...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | en |
| Published: |
Malaysian Medical Association
2023
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/116437/7/116437_Rare%20case%20of%20difficult%20intubation.pdf http://irep.iium.edu.my/116437/ https://www.e-mjm.org/ |
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| Summary: | We report a case of unanticipated difficult intubation due to
lingual tonsillar hypertrophy. This is a case of a 45-year-old
lady with hypertension undergoing Scarf Osteotomy and
Wedge osteotomy right first metatarsal bone and soft tissue
McBride procedure due to Bilateral hallux valgus stage 4
under general anaesthesia. Preoperative airway assessment
did not suggest a potentially tricky airway case. After an
uneventful induction, 3 attempts to intubate via direct
laryngoscopy and video laryngoscopy were undertaken;
however, they failed due to poor view. Attempts to ventilate
with a supraglottic airway device failed also, and the
decision was made to reverse the patient and postpone
surgery after investigating the reason for the difficult airway.
After Ear, Nose, and Throat (ENT) assessment, it was
ascertained that this patient's difficult intubation was due to
lingual tonsil hypertrophy. Lingual tonsil hypertrophy is
frequently asymptomatic and can be an anaesthetic
emergency if undiagnosed before anaesthesia. Lingual
tonsil hypertrophy causes difficulty in ventilation and
intubation. Fibreoptic intubation will be the preferred airway
management option for general anaesthesia patients with
known lingual tonsil hypertrophy. |
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