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Against the Odds: Safe Intubation in a Young Patient With a Massive Tonsillar Tumor
Ahmad Nabil1,2, Khaled S Abuamra2, Hatem Ibrahim2
1Department of Anesthesia and Intensive Care, Ain Shams University, Cairo, EGY.
Cureus
|July 7, 2025
Summary
Managing oropharyngeal tumors requires careful airway management and nasogastric tube (NGT) insertion. This case demonstrates successful nasotracheal intubation and NGT placement despite significant anatomical distortion from a pleomorphic adenoma.
Area of Science:
- Otolaryngology
- Anesthesiology
- Surgical Oncology
Background:
- Oropharyngeal tumors present complex challenges for airway management and nasogastric tube (NGT) insertion due to anatomical distortion.
- Pleomorphic adenomas are benign salivary gland neoplasms that can grow to significant sizes, impacting adjacent structures.
Observation:
- A young male patient with a large left oropharyngeal mass (pleomorphic adenoma) required specialized airway and nutritional access strategies.
- The tumor caused significant anatomical distortion, necessitating meticulous preprocedural planning.
Findings:
- Successful right-sided nasotracheal intubation was achieved using video laryngoscopy under general anesthesia.
- Preprocedural left-sided nasogastric tube insertion was completed without complications.
Implications:
- This case underscores the importance of strategic planning, including the use of video laryngoscopy and tailored NGT placement, for complex head and neck surgeries.
- Effective airway management and nutritional support are crucial for optimizing patient outcomes in cases of large oropharyngeal tumors.
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