Acute upper airway obstruction caused by massive oedema of the tongue: unusual complication of sialoendoscopy

To underline the importance of accurate clinical evaluation of major salivary gland obstructions, in order to choose the right surgical approach and to reduce the risk of complications. We report a case of an unusual, previously unreported upper airway obstruction caused by massive swelling of the t...

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Bibliographic Details
Published in:Journal of laryngology and otology 2009-12, Vol.123 (12), p.1402-1403
Main Authors: Baptista, P, Gimeno, C V, Salvinelli, F, Rinaldi, V, Casale, M
Format: Article
Language:English
Subjects:
Airway Obstruction - etiology
Biological and medical sciences
Complications
Edema - complications
Endoscopy
Endoscopy - adverse effects
Equipment Design
Female
Humans
Intubation, Intratracheal
Medical sciences
Oedema
Otorhinolaryngology. Stomatology
Salivary Gland Calculi - therapy
Salivary Glands
Sialadenitis - complications
Sialadenitis - therapy
Tongue
Tongue Diseases - complications
Treatment Outcome
Young Adult
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Summary:To underline the importance of accurate clinical evaluation of major salivary gland obstructions, in order to choose the right surgical approach and to reduce the risk of complications. We report a case of an unusual, previously unreported upper airway obstruction caused by massive swelling of the tongue following a successful sialoendoscopy, performed for treatment of submandibular sialolithiasis under general anaesthesia. Sialoendoscopy has gained popularity and is an accepted method for diagnosis and treatment of most inflammatory conditions of the major salivary glands. It can be performed as an out-patient procedure under local anaesthesia, and is not usually associated with significant complications. However, in the presence of larger stones (>4 mm) of the submandibular gland, we suggest that interventional sialoendoscopy should be performed under general anaesthesia with optimal airway control, in order to manage the major risk of perforations and ductal lesions enabling spread of saline solution into the mouth tissues and causing life-threatening swelling of the floor of the mouth and tongue.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215109005647