Massive Swelling of the Head and Neck

Ellis, Spencer; Bryan-Brown, Christopher W.; Hyderally, Hatim

doi:10.1097/00000542-197501000-00017

Cited by 50 publications

(19 citation statements)

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“…The authors postulate that the tongue was severely compressed by the endotracheal tube which causes necrotic slough and/or the swelling of the tongue may have resulted from venous occlusion of the tongue base with increased tongue size and secondary compression of the tongue against the tube in a confined space. Ellis et al suggested that an extreme flexion of the head against the chest during neurosurgical procedures may additionally compress airway, tube and tracheal rings against the base of the tongue [6]. However, in our case, the patient was placed in the horizontal position with the neck hyperextended.…”

Section: Discussionmentioning

confidence: 64%

Ischemic necrosis of the tongue following transoral neurosurgical procedure

Chakroun

Achour

Chaari

et al. 2014

Med Buccale Chir Buccale

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-Introduction: Postoperative, lingual swelling and necrosis are unusual complications that can lead to life-threatening airway obstruction. We report a case of bilateral ischemic necrosis of the tongue following transoral neurosurgical procedure. Observation: A Davis-Boyle mouth gag was used for tumor exposition and the operation lasted 8 h. At the end of the surgery, we noticed a bluish discoloration with a mild edema of the tongue. The patient had kept intubated in a monitored setting and intravenous steroids were administered. However, the edema increased and necrosis of the tongue appeared 72 h after the surgery. The patient underwent tracheotomy and the necrotic tissue was removed. More than 15 days passed before glossal engorgement resolved. Discussion: The etiology of tongue necrosis is likely related to tissue ischemia, secondary to venous or arterial obstruction. Prolonged use of the Davis-Boyle mouth gag may incur greater risk of ischemic necrosis of the tongue.Résumé -Nécrose ischémique de la langue après une intervention neuro-chirurgicale trans-orale. Introduction : Après une intervention chirurgicale, l'oedème et la nécrose de la langue représentent une complication rare qui peut entraîner une obstruction des voies aériennes mettant en jeu le pronostic vital. Un cas de nécrose ischémique bilatérale de la langue après une intervention neuro-chirurgicale trans-orale est rapporté. Observation : Un ouvre-bouche de Davis-Boyle a été utilisé pour aborder la tumeur et l'intervention a duré 8 h. À la fin de l'intervention, la langue présentait une couleur bleuâtre et un oedème modéré. La patiente a été gardée, intubée, dans l'unité de soins intensifs et des corticoïdes ont été injectés par voie intra-veineuse. L'oedème a augmenté et une nécrose de la langue est apparue 72 h après l'intervention. La patiente a été trachéotomisée et le tissu nécrotique excisé. L'oedème lingual a régressé en une quinzaine de jours. Discussion : La nécrose linguale est probablement due à une ischémie tissulaire, secondaire à une obstruction veineuse ou artérielle. L'utilisation prolongée de l'ouvre-bouche de Davis-Boyle augmente probablement le risque de nécrose ischémique de la langue.

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Section: Discussionmentioning

confidence: 64%

Ischemic necrosis of the tongue following transoral neurosurgical procedure

Chakroun

Achour

Chaari

et al. 2014

Med Buccale Chir Buccale

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“…13). Природа этого осложнения до конца не изучена, но по представлению некоторых авторов [25][26][27] а -МРТ до операции. Грубая компрессия стволовых структур и верхнешейного отдела спинного мозга (указана голубой стрелкой).…”

Section: Discussionunclassified

The algorithm for surgical treatment of skull base tumors invading the craniovertebral junction

et al. 2016

Vopr. neirokhir.

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“…There are several case reports documenting significant airway edema occurring in surgeries in the prone position. [8][9][10] Szabo et al reported a significant increase in laryngeal edema in patients undergoing surgery in the prone position as compared with the supine position, for operations lasting more than thee hours. 11 BhavaniShankar et al documented airway changes occurring in a parturient after fluid administration during Cesarean hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Case report: Anesthetic management for sequential Cesarean delivery and laminectomy

Al-Areibi

Coveney

Singh

et al. 2007

Can J Anesth/J Can Anesth

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Purpose: To describe the anesthetic considerations for a nearterm parturient with progressive cauda equina syndrome who required Cesarean delivery followed immediately by decompression lumbar discectomy and laminectomy in the prone position. Clinical features:A 33-yr-old woman presented at 35 weeks gestation with severe L5-S1 disc herniation causing motor and sensory neuronal dysfunction in the lower limbs accompanied by bowel and bladder dysfunction. After urgent multidisciplinary consultations, a decision was made to proceed with general anesthesia for Cesarean delivery in the supine position with left uterine displacement, followed immediately thereafter by L5-S1 discectomy and laminectomy in the prone position. Anesthesia concerns included the risks of hemorrhage from the combined surgeries and upper airway edema from the prone position, and the physiologic changes of pregnancy. The surgeries proceeded without complication, and both mother and baby recovered uneventfully. Conclusion:With a multidisciplinary approach, two surgeries in two different positions with unique anesthetic considerations were performed safely under general anesthesia in advanced pregnancy in a parturient with cauda equina syndrome. F EW cases of cauda equina syndrome during pregnancy have been reported in the literature. [1][2][3][4][5] Most of these cases involved cauda equina syndrome in parturients early in pregnancy (before 24 weeks of gestation.). Recently, Brown and Brookfield reported performing a Cesarean delivery and laminectomy in a parturient who was eight months pregnant. 5 Our case report is the first to discuss the anesthetic management of a parturient at 35 weeks gestation who underwent a Cesarean delivery followed by laminectomy in the prone position under the same general anesthetic for cauda equina syndrome. The patient gave written consent for publication of this information. CASE REPORTS/CASE SERIES 471CAN J ANESTH 54: 6 www.cja-jca

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Massive Swelling of the Head and Neck

Cited by 50 publications

References 0 publications

Ischemic necrosis of the tongue following transoral neurosurgical procedure

Ischemic necrosis of the tongue following transoral neurosurgical procedure

The algorithm for surgical treatment of skull base tumors invading the craniovertebral junction

Case report: Anesthetic management for sequential Cesarean delivery and laminectomy

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