[Tracheal intubation for two patients with lingual tonsil hyperplasia and prospect of difficult airway management].
Lingual tonsil hyperplasia is rare, but may cause difficult or inpossible tracheal intubation. We experienced two cases of tracheal intubation for lingual tonsil hyperplasia. A 71-yr-old man was scheduled for resection and biopsy of symptomatic hypertrophied lingual tonsils. In this patient, we performed oro-tracheal intubation by rigid laryngoscopy from left oral angle, because left hypertrophied lingual tonsils are smaller than those on the right side. A 44-yr-old man was scheduled for resection of symptomatic hypertrophied lingual tonsils after lingual tonsillitis. In this patient, we performed nasotracheal intubation using fiberoptic bronchoscopy with assist of jaw-lift and tongue-extension. When an anesthesiologist can predict the abnormality of lingual tonsils, these methods might be recommended for difficult airway and intubation. However, it is necessary to prepare a difficult airway management set including laryngeal mask airway, intubating laryngeal mask airway, fiberoptic bronchos-copy and transcutaneous tracheotomy set. And most important is preliminary evaluation of airway and cautious planning of tracheal intubation.
Myojo
Yasuhiro
Y
Department of Anesthesia and Intensive Care, Takaoka City Hospital, Takaoka.
Tohyama
Kazuki
K
Taki
Yasunori
Y
Kamiutsuri
Kei
K
D000328:Adult; D000368:Aged; D006801:Humans; D006965:Hyperplasia; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology*; D014068:Tonsillectomy