Related Experiment Video
Updated: Jun 28, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation
Published on: August 2, 2024
[Difficult airway management due to obesity and lingual tonsillar hyperplasia]
Ryoji Obata1, Yuji Adachi, Hiroshi Igarashi
1Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu 431-3192.
Abstract:
We experienced anesthesia for a female patient of BMI 39.2 with unanticipated lingual tonsillar hyperplasia. At the induction of anesthesia, both mask ventilation and tracheal intubation were difficult due to the lingual tonsillar hyperplasia. However, tracheal intubation was performed by Intubating LMA with the fiberoptic bronchoscopy. After the placing of TE (the catheter for tracheal tube exchanger), the tracheal tube was extubated without any airway trouble. Following the extubation, the opening of the respiratory tract was evaluated by TE and the fiberoptic bronchoscopy. In this case we confirmed that the ASA difficult airway algorithm was also useful in the presence of lingual tonsillar hyperplasia.
Related Concept Videos
Cardiopulmonary Resuscitation II: ACLS Airway Management
Tonsillitis II: Management
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...

