Penetrating injury to the soft palate causing retropharyngeal air collection

Although endotracheal intubation is commonly performed in the hospital setting, it is not without risk. In this article, we review the impact of endotracheal intubation on airway injury by describing the acute and long-term sequelae of each of the most commonly injured anatomic sites along the respiratory tract, including the nasal cavity, oral cavity, oropharynx, larynx, and trachea. Injuries covered include nasoseptal injury, tongue injury, dental injury, mucosal lacerations, vocal cord immobility, and laryngotracheal stenosis, as well as tracheomalacia, tracheoinnominate, and tracheoesophageal fistulas. We discuss the proposed mechanisms of tissue damage that relate to each and present their most common clinical manifestations, along with their respective diagnostic and management options. This article also includes a review of complications of airway management pertaining to video laryngoscopy and supraglottic airway devices. Finally, potential strategies to prevent intubation-associated injuries are outlined.

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“…Mediastinitis and internal carotid thrombosis have also been described after oropharyngeal perforations, but these are exceedingly rare. 46,47 …”

Section: Injury By Anatomic Sitementioning

confidence: 99%

Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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“…More serious complications of soft palate perforations include internal carotid artery thrombosis or pseudoaneurysm, thrombosis of the internal jugular vein, and mediastinitis [11][12][13]. Perforations near the midline (which occurred in the present case) are less likely to result in carotid artery injury, as contrasted with lateral lesions, which are anatomically closer to the internal carotid artery as it courses posteriorly to the tonsillar fossa [14].…”

Section: Discussionmentioning

confidence: 59%

Soft palate perforation during orotracheal intubation facilitated by the GlideScope videolaryngoscope

Vincent

Wimberly

Brockwell

et al. 2007

Journal of Clinical Anesthesia

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“…A review of the literature revealed the etiologies of retropharyngeal air to include trauma, infection, violent coughing, asthma exacerbation, Valsalva maneuver, illicit drug use, and dental manipulation (1)(2)(3). From the patient's history, surgical exploration, and culture results, none of these etiologies seem to readily fit our patient.…”

Section: Discussionmentioning

confidence: 68%