Rare case of difficult intubation: lingual tonsillar hypertrophy : case report

Ghazali, Abdul Majid and Singh Sran, Surrej Darshain and Ti, Phing Phang and Azmi, Nurul Izzah (2023) Rare case of difficult intubation: lingual tonsillar hypertrophy : case report. MJM Case Reports Journal, 2 (3). pp. 186-188. ISSN 2948-3859

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Abstract

We report a case of unanticipated difficult intubation due to lingual tonsillar hypertrophy. This is a case of a 45-year-old lady with hypertension undergoing Scarf Osteotomy and Wedge osteotomy right first metatarsal bone and soft tissue McBride procedure due to Bilateral hallux valgus stage 4 under general anaesthesia. Preoperative airway assessment did not suggest a potentially tricky airway case. After an uneventful induction, 3 attempts to intubate via direct laryngoscopy and video laryngoscopy were undertaken; however, they failed due to poor view. Attempts to ventilate with a supraglottic airway device failed also, and the decision was made to reverse the patient and postpone surgery after investigating the reason for the difficult airway. After Ear, Nose, and Throat (ENT) assessment, it was ascertained that this patient's difficult intubation was due to lingual tonsil hypertrophy. Lingual tonsil hypertrophy is frequently asymptomatic and can be an anaesthetic emergency if undiagnosed before anaesthesia. Lingual tonsil hypertrophy causes difficulty in ventilation and intubation. Fibreoptic intubation will be the preferred airway management option for general anaesthesia patients with known lingual tonsil hypertrophy.

Item Type:	Article (Case Report)
Uncontrolled Keywords:	Ear, Nose, and Throat (ENT) Non-steroidal anti-inflammatory drugs(NSAIDs) difficult airway society (DAS)
Subjects:	R Medicine > RD Surgery > RD81 Anesthesiology
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	dr abdul majid bin ghazali
Date Deposited:	05 Dec 2024 12:47
Last Modified:	05 Dec 2024 14:50
URI:	http://irep.iium.edu.my/id/eprint/116437

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