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Anesthetic concerns in a huge congenital sublingual swelling obscuring airway access.

Kumar N, Bindra A, Kumar N, Yadav N, Sharma S - Saudi J Anaesth (2015 Apr-Jun)

Bottom Line: Presence of intraoral pathology poses a great challenge during management of pediatric airway.Airway patency is at risk in postoperative period also, in this case, though the swelling decreased in size postoperatively but presence of significant edema required placement of tongue stitch and modified nasopharyngeal airway.Case report highlights simple maneuvers to manage a difficult case.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Jai Prakash Narain Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Presence of intraoral pathology poses a great challenge during management of pediatric airway. We report management of big intraoral cystic swelling physically occupying the entire oral cavity restricting access to airway. Preintubation aspiration of swelling was done to decrease its size and make room for airway manipulation, followed by laryngoscopy and intubation in lateral position. Airway patency is at risk in postoperative period also, in this case, though the swelling decreased in size postoperatively but presence of significant edema required placement of tongue stitch and modified nasopharyngeal airway. Case report highlights simple maneuvers to manage a difficult case.

No MeSH data available.


Related in: MedlinePlus

Photograph of the child showing intraoral swelling occupying oral cavity.
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Figure 1: Photograph of the child showing intraoral swelling occupying oral cavity.

Mentions: A 15 month, 14 kg, male child presented with large sublingual swelling completely obliterating oral cavity. [Figure 1] The swelling was small at birth and progressively enlarged over time. Local examination revealed huge swelling arising from ventrum of tongue pushing it towards palate. Child was only able to take liquids per os. Both nostrils were patent. Rest of the physical examination and blood reports were unremarkable. A provisional diagnosis of ranula was made. Surgical excision of cyst was planned under general anesthesia. The swelling was huge, not allowing anything to pass over it so it was decided to aspirate it and make room for airway manipulation.


Anesthetic concerns in a huge congenital sublingual swelling obscuring airway access.

Kumar N, Bindra A, Kumar N, Yadav N, Sharma S - Saudi J Anaesth (2015 Apr-Jun)

Photograph of the child showing intraoral swelling occupying oral cavity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374229&req=5

Figure 1: Photograph of the child showing intraoral swelling occupying oral cavity.
Mentions: A 15 month, 14 kg, male child presented with large sublingual swelling completely obliterating oral cavity. [Figure 1] The swelling was small at birth and progressively enlarged over time. Local examination revealed huge swelling arising from ventrum of tongue pushing it towards palate. Child was only able to take liquids per os. Both nostrils were patent. Rest of the physical examination and blood reports were unremarkable. A provisional diagnosis of ranula was made. Surgical excision of cyst was planned under general anesthesia. The swelling was huge, not allowing anything to pass over it so it was decided to aspirate it and make room for airway manipulation.

Bottom Line: Presence of intraoral pathology poses a great challenge during management of pediatric airway.Airway patency is at risk in postoperative period also, in this case, though the swelling decreased in size postoperatively but presence of significant edema required placement of tongue stitch and modified nasopharyngeal airway.Case report highlights simple maneuvers to manage a difficult case.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Jai Prakash Narain Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Presence of intraoral pathology poses a great challenge during management of pediatric airway. We report management of big intraoral cystic swelling physically occupying the entire oral cavity restricting access to airway. Preintubation aspiration of swelling was done to decrease its size and make room for airway manipulation, followed by laryngoscopy and intubation in lateral position. Airway patency is at risk in postoperative period also, in this case, though the swelling decreased in size postoperatively but presence of significant edema required placement of tongue stitch and modified nasopharyngeal airway. Case report highlights simple maneuvers to manage a difficult case.

No MeSH data available.


Related in: MedlinePlus