A novel approach to managing circumferential entrapment of a child's tongue within a plastic lid

Abstract

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.