Lingual tonsillar hypertrophy causing failed intubation and cerebral anoxia

Area of Science:

• Otolaryngology
• Anesthesiology
• Medical Case Reports

Background:

• Lingual tonsil hypertrophy is an uncommon condition.
• It can lead to airway obstruction, sleep apnea, and recurrent epiglottitis.
• Difficult anesthetic intubation has been reported in pediatric cases.

Observation:

• A 24-year-old woman presented for an appendectomy.
• She had markedly hypertrophied lingual tonsils.
• These enlarged tonsils obstructed the airway, preventing intubation.

Findings:

• The patient's lingual tonsil hypertrophy posed a significant airway management challenge.
• Endotracheal intubation was not possible after anesthetic induction and muscle relaxation.
• This case underscores the potential for lingual tonsil enlargement to complicate airway management in adults.

Implications:

• Clinicians should consider lingual tonsil hypertrophy in the differential diagnosis of difficult airways.
• Enhanced preoperative airway assessment is crucial in patients with suspected lingual tonsil enlargement.
• This condition requires specialized anesthetic and airway management strategies.