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

Published online by Cambridge University Press:  27 May 2009

P Baptista
Affiliation:
Department of Otolaryngology, Clinica Universitaria, Facultad de Medicina, Universidad de Navarra, Italy
C V Gimeno
Affiliation:
Department of Otolaryngology, Clinica Universitaria, Facultad de Medicina, Universidad de Navarra, Italy
F Salvinelli
Affiliation:
Department of Otolaryngology, Campus Bio-Medico University, Rome, Italy
V Rinaldi
Affiliation:
Department of Otolaryngology, Campus Bio-Medico University, Rome, Italy
M Casale*
Affiliation:
Department of Otolaryngology, Campus Bio-Medico University, Rome, Italy
*
Address for correspondence: Dr Manuele Casale, Department of Otolaryngology, Campus Bio-Medico University, School of Medicine, Via Alvaro del Portillo, 21-00128 Rome, Italy. Fax: +39 06 22541 456 E-mail: [email protected]

Abstract

Objective:

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.

Case report:

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.

Conclusions:

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2009

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References

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