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Updated: May 18, 2026
04:04
Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
Published on: August 15, 2025
[Unexpectedly complicated laryngoscopy caused by a massive mandibular tori]
Sari Suzuki1, Hirofumi Hino, Moriyoshi Ohji
1Department of Anesthesiology, St. Marianna University School of Medicine, Kawasaki 216-8511.
Masui. the Japanese Journal of Anesthesiology
|September 21, 2012
Summary
Massive mandibular tori can unexpectedly complicate laryngoscopy, even when standard intubation predictors are normal. Preoperative oral evaluation is crucial for identifying these benign growths that can impede airway visualization.
Area of Science:
- Anesthesiology
- Oral Surgery
Background:
- Standard predictors like thyromental distance and Mallampati score suggested normal intubation conditions.
- A 64-year-old male with a history of mitral and aortic regurgitation was scheduled for double valve replacement.
Observation:
- Massive mandibular tori, undetected preoperatively, severely obstructed direct laryngoscopy.
- Initial attempts at direct laryngoscopy failed due to the anatomical anomaly.
Findings:
- Specialized equipment, including a McCoy laryngoscope and gum elastic bougie, was required for successful intubation.
- Intubation was ultimately achieved on the third attempt using a 7.5 mm tube.
Implications:
- Mandibular tori, though often asymptomatic, pose a significant risk for difficult laryngoscopy and airway management.
- Highlights the critical importance of thorough preoperative oral cavity evaluation in all patients undergoing anesthesia.
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