Uvulitis following general anaesthesia

Supraglottic airway devices are routinely used for airway maintenance in elective surgical procedures where aspiration is not a significant risk and also as rescue devices in difficult airway management. Some devices now have features mitigating risk of aspiration, such as drain tubes or compartments to manage regurgitated content. Despite this, the use of these device may be associated with various complications including aspiration. This review highlights the types and incidence of these complications. They include regurgitation and aspiration of gastric contents, compression of vascular structures, trauma, and nerve injury. The incidence of such complications is quite low, but as some carry with them a significant degree of morbidity the need to follow manufacturers' advice is underlined. The incidence of gastric content aspiration associated with the devices is estimated to be as low as 0.02% with perioperative regurgitation being significantly higher but underreported. Other serious, but extremely rare, complications include pharyngeal rupture, pneumomediastinum, mediastinitis, or arytenoid dislocation. Mild short-lasting adverse effects of the devices have significantly higher incidence than serious complications and involve postoperative sore throat, dysphagia, pain on swallowing, or hoarseness. Devices may have deleterious effect on cervical mucosa or vasculature depending on their cuff volume and pressure.

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“…Trauma to the uvula or uvulitis has been described following insertion of laryngeal mask airway [ 75 ].…”

Section: Complicationsmentioning

confidence: 99%

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Michálek

Donaldson

Vobrubová

et al. 2015

BioMed Research International

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“…Trauma is the most common cause of noninfectious causes of uvulitis. Traumatic uvulitis has been described after endotracheal, orogastric, or nasal tubes, endoscopy, oropharyngeal suctioning after traumatic adenoidectomy, and laryngeal mask airway use [18][19][20][21][22][23][24][25]. Uvular edema and inflammation may follow cannabis, marijuana, or cocaine inhalation due to thermal irritation or allergic reaction [26][27][28][29].…”

Section: Etiologymentioning

confidence: 99%

“…In patients with compression uvulitis due to oropharyngeal and nasopharyngeal tubes, endotracheal intubation, or endoscopy, appearing of the distal uvula may be erythematous, ecchymotic, or whitish-gray [20,23,24]. Traumatic uvulitis should be suspected in a child with uvular edema after extubation [24].…”

Section: Diagnosismentioning

confidence: 99%

Uvulitis in Children

Ecevit

Jones

2021

Pediatric ENT Infections

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Postoperative uvular necrosis: A case series and literature review

et al. 2019

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Objectives/Hypothesis Postoperative uvular necrosis is rare, but can be distressing to the patient when it unexpectedly occurs. Little has been published regarding its predisposing factors and pathophysiology. The purpose of this comprehensive review was to compile cases of postoperative uvular necrosis and identify risk factors and potential causes for this complication. Study Design Retrospective case series. Methods The study was performed at an academic tertiary care referral center. Clinical records from four patients treated for postoperative uvular necrosis from 2008 to 2018 were reviewed. A comprehensive literature review was also performed. The MEDLINE, Embase, and Scopus databases were searched, as well as the grey literature. All case reports and literature reviews in the English literature from 1978 to 2018 were systematically identified for review. Results Four cases of postoperative uvular necrosis diagnosed clinically at our institution were included. The comprehensive literature review identified 26 reports and seven case series, totaling 53 cases of this complication. Use of suction was reported in 19 cases, and six cases reported no use of suction. Ninety‐four percent of cases were treated conservatively, whereas 6% underwent excision. Ninety‐one percent resolved within 14 days. Conclusions Impingement with various devices and vascular trauma from suction each likely play a role in postoperative uvular necrosis. Male oropharyngeal anatomy may be a risk factor, but neither the type of instrumentation nor the type of procedure seem to predict this complication. Proper positioning of the patient and instruments and minimizing suction force help prevent uvular injury. Level of Evidence NA Laryngoscope, 130:880–885, 2020

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Uvulitis following general anaesthesia

Abstract: Uvular necrosis following endotracheal general anaesthesia is a rare complication. We report two cases of uvular and soft palate necrosis after atraumatic intubation with endotracheal tube and, in the second case, laryngeal mask airway.

Cited by 5 publications

References 15 publications

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Uvulitis in Children

Postoperative uvular necrosis: A case series and literature review

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