Easy endotracheal intubation of a patient suffering from both Cushing's and Nelson's syndromes predicted by the upper lip bite test despite a Mallampati Class 4 airway.
A 31-yr-old woman with concurrent Cushing's and Nelson's syndromes was scheduled for transsphenoidal hypophysectomy. The patient had generalized edema, morbid obesity, and a history of sleep apnea. Her Mallampati assessment was Class 4, suggesting very difficult intubation, but the upper lip bite test predicted easy intubation. After rapid sequence induction, there was a Class 1 view on laryngoscopy, and intubation was accomplished easily.
Khan
Zahid Hussain
ZH
Department of Anesthesiology, School of Medicine, Medical Sciences/University of Tehran, Imam Khomeni Medical Center, Tehran, Iran. khanhzh51@yahoo.com
Gharabaghian
Mahin
M
Nilli
Ferozeh
F
Ghiamat
Mehdi
M
Mohammadi
Mostafa
M
D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D003480:Cushing Syndrome / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007574:Jaw Relation Record; D007828:Laryngoscopy; D008046:Lip / Q000473:pathology; D009347:Nelson Syndrome / Q000150:complications* / Q000473:pathology; D015203:Reproducibility of Results; D012137:Respiratory System / Q000473:pathology*; D014070:Tooth / Q000473:pathology