title: Penetrating injury of the palatoglossal arch associated with use of the GlideScope videolaryngoscope in a flame burn patient.
abstract: The GlideScope is used to facilitate exposure of the larynx in both routine and difficult airways. A 38-year-old woman with a flame burn (second/third-degree, 40% total body surface area) and inhalation injury accompanied by acute respiratory failure under mechanical ventilation support presented for wound debridement and split thickness skin grafting. After the surgery, the endotracheal tube was reinserted successfully with a GlideScope because we anticipated a problematic airway. However, direct laryngoscopy revealed the endotracheal tube had pierced through the right palatoglossal arch. Because the consulting otolaryngologist confirmed there was no active bleeding, it was decided that no further management was needed for the wound; the patient was re-intubated under direct laryngoscopy. Postoperatively, she was transferred to the intensive care unit of the burn center under mechanical ventilation. This is a report on a rare complication caused by tracheal intubation associated with the use of the GlideScope. We recommend manipulation of the GlideScope should be performed with care under vigilant surveillance to minimize injury to the oropharyngeal tissues when an endotracheal tube is advanced from the mouth to the pharynx. Potential complications should be always kept in mind when the GlideScope is used for intubation.
authors.affiliation: Department of Anesthesiology, Changhua Christian Hospital, 135 Nan-Hsiao Street, Changhua, Taiwan, R.O.C.
authors.forename: Wei-Ti
authors.initials: WT
authors.lastname: Hsu
authors.forename: Shao-Lun
authors.initials: SL
authors.lastname: Tsao
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Chen
authors.forename: Wei-Kang
authors.initials: WK
authors.lastname: Chou
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D020704:Laryngoscopes / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000209:etiology*