title: Acute upper airway obstruction caused by massive oedema of the tongue: unusual complication of sialoendoscopy.
abstract: OBJECTIVE
  To underline the importance of accurate clinical evaluation of major salivary gland obstructions, in order to choose the right surgical approach and to reduce the risk of complications.
  
  
  METHODS
  We report a case of an unusual, previously unreported upper airway obstruction caused by massive swelling of the tongue following a successful sialoendoscopy, performed for treatment of submandibular sialolithiasis under general anaesthesia.
  
  
  CONCLUSIONS
  Sialoendoscopy has gained popularity and is an accepted method for diagnosis and treatment of most inflammatory conditions of the major salivary glands. It can be performed as an out-patient procedure under local anaesthesia, and is not usually associated with significant complications. However, in the presence of larger stones (>4 mm) of the submandibular gland, we suggest that interventional sialoendoscopy should be performed under general anaesthesia with optimal airway control, in order to manage the major risk of perforations and ductal lesions enabling spread of saline solution into the mouth tissues and causing life-threatening swelling of the floor of the mouth and tongue.
authors.affiliation: Department of Otolaryngology, Clinica Universitaria, Facultad de Medicina, Universidad de Navarra, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Baptista
authors.forename: C V
authors.initials: CV
authors.lastname: Gimeno
authors.forename: F
authors.initials: F
authors.lastname: Salvinelli
authors.forename: V
authors.initials: V
authors.lastname: Rinaldi
authors.forename: M
authors.initials: M
authors.lastname: Casale
mesh_terms: D000402:Airway Obstruction / Q000209:etiology*; D004487:Edema / Q000150:complications*; D004724:Endoscopy / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D015494:Salivary Gland Calculi / Q000628:therapy; D012793:Sialadenitis / Q000150:complications / Q000628:therapy*; D014060:Tongue Diseases / Q000150:complications*; D016896:Treatment Outcome; D055815:Young Adult