The Unexpected Difficult Airway and Lingual Tonsil Hyperplasia

Ovassapian, Andranik; Glassenberg, Raymond; Randel, Gail I.; Klock, Allan; Mesnick, Paul S.; Klafta, Jerome M.

doi:10.1097/00000542-200207000-00018

Cited by 112 publications

(72 citation statements)

References 1 publication

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“…Diagnosed and undiagnosed laryngeal disease is a more frequent contributor to CICO than generally realised [19,20]. Out of the 58 cases of EPA in 133 anaesthetic patients reported to NAP4, 43 (74%) were head ⁄ neck cases [12], suggesting a significantly increased risk in this patient population.…”

Section: Incidence and Causation Of Cicomentioning

confidence: 99%

Equipment and strategies for emergency tracheal access in the adult patient

Hamaekers

Henderson

2011

Anaesthesia

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SummaryThe inability to maintain oxygenation by non‐invasive means is one of the most pressing emergencies in anaesthesia and emergency care. To prevent hypoxic brain damage and death in a ‘cannot intubate, cannot oxygenate’ situation, emergency percutaneous airway access must be performed immediately. Even though this emergency is rare, every anaesthetist should be capable of performing an emergency percutaneous airway as the situation may arise unexpectedly. Clear knowledge of the anatomy and the insertion technique, and repeated skill training are essential to ensure completion of this procedure rapidly and successfully. Various techniques have been described for emergency oxygenation and several commercial emergency cricothyroidotomy sets are available. There is, however, no consensus on the best technique or device. As each has its limitations, it is recommended that all anaesthetists are skilled in more than one technique of emergency percutaneous airway. Avoiding delay in initiating rescue techniques is at least as important as choice of device in determining outcome.

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Section: Incidence and Causation Of Cicomentioning

confidence: 99%

Equipment and strategies for emergency tracheal access in the adult patient

Hamaekers

Henderson

2011

Anaesthesia

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“…Benign lingual tonsillar hyperplasia is a recognized cause of respiratory obstruction contributing to difficult mask ventilation and tracheal intubation [2,[4][5][6][7][8][9][10][11]. Asymptomatic lingual tonsillar hyperplasia, in fact, is not so rare.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical symptoms of lingual tonsillar hyperplasia include sore throat, globus sensation, changes in speech, dysphagia, hoarseness, snoring, feeling of a lump in the throat, obstructive sleep apnea, and otalgia [2,9,12]. These symptoms should alert clinicians to its presence.…”

Section: Discussionmentioning

confidence: 99%

Unexpected difficult intubation due to lingual tonsillar hyperplasia in a thoracotomy patient: intubation with the double-lumen tube using stylet and fiberoptic bronchoscopy

Orhan¹,

Gözübüyük²,

Sızlan³

et al. 2009

Journal of Clinical Anesthesia

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“…(11) Inflammatory causes include subglottic/tracheal stenosis, (7) goitre (12) and lingual tonsillar hypertrophy. (13) Neoplastic causes include laryngeal or tracheobronchial cancers, (14) and those associated with mediastinal mass syndrome. (15) 80% of emergency awake tracheostomies are related to malignant disease.…”

Section: Causes Location and Degree Of Obstructionmentioning

confidence: 99%

“…These patients may, therefore, present as unanticipated cases of difficult airway, which may lead to serious morbidity and even death. (13,22) Diagnostic information is important to determine the location and degree of AAO, and whether it is an annular and/or fixed, or a large pedunculated or 'ball valve' type. The latter requires the patient to maintain spontaneous ventilation (SV).…”

Section: Causes Location and Degree Of Obstructionmentioning

confidence: 99%

Anaesthetic management of acute airway obstruction

Wong¹,

Wong²,

Mok³

2016

smedj

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The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the United Kingdom's 4th National Audit Project on major airway complications in 2011 and the updated American Society of Anesthesiologists' difficult airway algorithm of 2013, have recently been published. The former contained many reports of adverse events associated with the management of acute airway obstruction. By analysing the data and concepts from these two publications, this review article provides an update on management techniques for the acutely obstructed airway. We discuss the principles and factors relevant to the decision-making process in formulating a logical management plan.

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The Unexpected Difficult Airway and Lingual Tonsil Hyperplasia

Abstract: Lingual tonsil hyperplasia can interfere with rigid laryngoscopic intubation and face mask ventilation. Routine physical examination of the airway will not identify its presence. The prevalence of LTH in adults and the extent of its contribution to failed intubation is unknown.

Cited by 112 publications

References 1 publication

Equipment and strategies for emergency tracheal access in the adult patient

Equipment and strategies for emergency tracheal access in the adult patient

Unexpected difficult intubation due to lingual tonsillar hyperplasia in a thoracotomy patient: intubation with the double-lumen tube using stylet and fiberoptic bronchoscopy

Anaesthetic management of acute airway obstruction

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