Perforation of and Intubation through the Palatoglossal Fold

Ds, Bartlett; Grace, Robert F; Newell, S

doi:10.1177/0310057x0903700315

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…When loading an endotracheal tube with a stylet, the stylet should not protrude beyond the end of the tube, to avoid iatrogenic laceration of pharyngeal or tracheal structures [16] . Attempting to pass instrumentation through the pharynx against resistance can also result in significant injury [ 2 , 17 , 18 ]. This skill is important for emergency medicine physicians to master so they are cognizant of the risk of iatrogenic injury during ETI procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Although rare, iatrogenic injuries from ETI can be potentially life-threatening. One such complication is perforation of pharyngeal structures [2] , [3] , [4] , [5] , [6] , [7] , [8] which can lead to infection with subsequent abscess formation and airway compromise [9] . Infections in this region can also dissect through the deep cervical fascia and into the mediastinum, resulting in life-threatening mediastinitis [10] .…”

Section: Introductionmentioning

confidence: 99%

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Deep neck abscess after intubation trauma: a case report

Kaul¹,

Nayak²,

Jacoby³

et al. 2022

Radiology Case Reports

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Significant injuries from endotracheal intubation are exceedingly rare but can lead to life-threatening complications, such as pharyngeal perforation. This type of perforation can result in abscess formation and airway compromise. Risks for this complication include operator skill and intubation in emergent situations. This case report details a 59-year-old male who underwent elective septoplasty with bilateral nasal turbinate reduction. The procedure required general anesthesia induction and endotracheal intubation. He developed a gradually enlarging right-sided neck mass with associated fevers, neck pain, odynophagia, and dysphonia. He presented to the emergency department on postoperative day 5 and was diagnosed with a right-sided, prevertebral space abscess with airway mass effect secondary to pharyngeal perforation. He was admitted for operative management, intravenous antibiotics, and was successfully treated. While significant injury from endotracheal intubation is rare, it can result in infection and threaten airway patency. Emergency physicians must recognize pharyngeal perforation as a potential source of infection following instrumentation of the pharynx. This case has been reported to increase awareness of the potential for such injury.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Deep neck abscess after intubation trauma: a case report

Kaul¹,

Nayak²,

Jacoby³

et al. 2022

Radiology Case Reports

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“…Although infrequent these injuries include lacerations of the pharyngeal structures such as the soft palate and palatoglossal fold, as well as the esophagus, which can result in severe hemorrhage that obscures visualization during laryngoscopy for tracheal intubation [3, 4]. These injuries can create a false lumen with potential for catastrophic outcomes such as pneumomediastinum, infection, or even lack of ventilation [5, 6].…”

Section: Introductionmentioning

confidence: 99%

A Rare Complication of Tracheal Intubation: Tongue Perforation

Lollo

Meyer

Grabinsky

2012

Case Reports in Anesthesiology

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Aim. To describe the subsequent treatment of airway trauma sustained during laryngoscopy and endotracheal intubation. Methods. A rare injury occurring during laryngoscopy and endotracheal intubation that resulted in perforation of the tongue by an endotracheal tube and the subsequent management of this unusual complication are discussed. A 65-year-old female with intraparenchymal brain hemorrhage with rapidly progressive neurologic deterioration had the airway secured prior to arrival at the referral institution. The endotracheal tube (ETT) was noted to have pierced through the base of the tongue and entered the trachea, and the patient underwent operative laryngoscopy to inspect the injury and the ETT was replaced by tracheostomy. Results. Laryngoscopy demonstrated the ETT to perforate the base of the tongue. The airway was secured with tracheostomy and the ETT was removed. Conclusions. A wide variety of complications resulting from direct and video-assisted laryngoscopy and tracheal intubation have been reported. Direct perforation of the tongue with an ETT and ability to ventilate and oxygenate subsequently is a rare injury.

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