Retrograde Endotracheal Intubation with Laryngeal Mask Airway in a Patient with Lingual Tonsillar Hypertrophy.

Enya, Satoshi; Yoshiyama, Toshiyuki; Chuma, Riichiroh

doi:10.2199/jjsca.15.703

Cited by 2 publications

(3 citation statements)

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“…We retrieved 48 articles: 34 in English, 2,5,9,15 –45 nine in Japanese, 46 –54 two in Spanish, 55,56 one in Korean, 57 one in French, 58 and one in Italian. 59 These articles described a total of 89 patients and 92 cases (see Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…‘Non-standard airway techniques’ were those other than the conventional use of the above airway techniques (supraglottic airway, direct and videolaryngoscopy, FBI and SGI), and were mainly performed after more conventional techniques had failed. They included bougie guided Pro-Seal LMA insertion, 22 light wand guided intubation, 24,48 FBI by a stylet guided double lumen tube, 39 direct or videolaryngoscopy facilitating FBI, 57 rigid bronchoscopy, 23 retrograde wire guided intubation, 18,43,47 surgical laryngoscopy, 26 and laryngeal tube. 37 Further description of these are beyond the scope of this review.…”

Section: Resultsmentioning

confidence: 99%

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Airway management of lingual tonsillar hypertrophy: A narrative review

Wong,

Sleigh

2023

Anaesth Intensive Care

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Lingual tonsillar hypertrophy is rarely identified on routine airway assessment but may cause difficulties in airway management. We conducted a narrative review of case reports of lingual tonsillar hypertrophy to examine associated patient factors, success rates of airway management techniques and complications. We searched the literature for anaesthetic management of cases with lingual tonsillar hypertrophy. We found 89 patients in various case reports, from which we derived 92 cases to analyse. 64% of cases were assessed as having a normal airway. Difficult and impossible face mask ventilation occurred in 29.6% and 1.4% of cases, respectively. Difficult intubation and failed intubation occurred in 89.1% and 21.7% of cases, respectively. Multiple attempts (up to six) at intubation were performed, with no successful intubation after the third attempt with direct laryngoscopy. Some 16.5% of patients were woken up and 4.3% required emergency front of neck access. Complications included oesophageal intubation (10.9%), bleeding (9.8%) and severe hypoxia (3.2%). Our findings show that severe cases of lingual hypertrophy may cause an unanticipated difficult airway and serious complications, including hypoxic brain damage and death. A robust airway strategy is required which includes limiting the number of attempts at laryngoscopy, and early priming and performance of emergency front of neck access if required. In patients with known severe lingual tonsillar hypertrophy, awake intubation should be considered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Airway management of lingual tonsillar hypertrophy: A narrative review

Wong,

Sleigh

2023

Anaesth Intensive Care

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“…Golding-Wood et al [7] identified only 25 patients in a retrospective screening of notes from a 26-year period. However, Jones et al [6] and some anesthesiologists have reported unexpected difficult airways that might have been caused by lingual tonsil hypertrophy [5,[13][14][15].…”

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confidence: 99%