A novel approach to managing circumferential entrapment of a child's tongue within a plastic lid
Related Experiment Video
Updated: Oct 4, 2025
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
A Selwyn1, C V Praveen1, R De Silva2
1Department of ENT, Medway Maritime Hospital, Gillingham, Kent, UK.
Insights
Reusable drinking bottles pose risks for children. Two cases of tongue entrapment in bottle lids required surgery, highlighting unique anesthetic and surgical challenges for pediatric foreign body removal.
Area of Science:
- Otolaryngology
- Pediatric Emergency Medicine
- Anesthesiology
Background:
- Reusable drinking bottles are increasingly popular among children.
- This popularity raises safety concerns, particularly regarding potential injuries.
- This study addresses complications arising from children's use of these bottles.
Observation:
- Two five-year-old children presented with their tongues circumferentially entrapped in plastic drinking bottle lids.
- The bottle lids were of a similar design, suggesting a potential product safety issue.
- Both cases necessitated surgical intervention due to the foreign body entrapment.
Findings:
- These are the only reported cases of tongue entrapment by a foreign body requiring general anesthesia where orotracheal intubation was contraindicated.
- A novel anesthetic approach was successfully employed using ketamine and high-flow nasal oxygen therapy (Optiflow).
- A reproducible surgical technique utilizing powered cutting instruments was developed and is discussed.
Implications:
- Highlights the potential for serious pediatric foreign body injuries related to common household items.
- Demonstrates the feasibility of alternative anesthetic techniques in challenging pediatric airway cases.
- Provides a valuable surgical approach for managing similar foreign body entrapments, improving patient outcomes.
Background:
The increased popularity of reusable drinking bottles may have safety implications when used by children. This paper discusses the lessons learnt from managing two cases of children presenting to our ENT department who required surgical intervention for complications arising from their use.
Case Report:
This paper presents a case series of two five-year-old children who attended the emergency department with circumferential entrapment of their tongue within plastic drinking bottle lids of similar design. The unique anaesthetic and surgical challenges surrounding these cases are discussed.
Conclusion:
These represent the only reported cases of circumferential entrapment of the tongue by a foreign body requiring general anaesthesia where orotracheal intubation was contraindicated. A creative general anaesthetic approach was taken using ketamine and Optiflow high-flow nasal oxygen therapy. A reproducible surgical technique using powered cutting instruments is also discussed.
Related Concept Videos
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required