Myojo Yasuhiro, Tohyama Kazuki, Taki Yasunori, Kamiutsuri Kei
Department of Anesthesia and Intensive Care, Takaoka City Hospital, Takaoka.
Masui. 2005 Jul;54(7):776-82.
Lingual tonsil hyperplasia is rare, but may cause difficult or inpossible tracheal intubation. We experienced two cases of tracheal intubation for lingual tonsil hyperplasia. A 71-yr-old man was scheduled for resection and biopsy of symptomatic hypertrophied lingual tonsils. In this patient, we performed oro-tracheal intubation by rigid laryngoscopy from left oral angle, because left hypertrophied lingual tonsils are smaller than those on the right side. A 44-yr-old man was scheduled for resection of symptomatic hypertrophied lingual tonsils after lingual tonsillitis. In this patient, we performed nasotracheal intubation using fiberoptic bronchoscopy with assist of jaw-lift and tongue-extension. When an anesthesiologist can predict the abnormality of lingual tonsils, these methods might be recommended for difficult airway and intubation. However, it is necessary to prepare a difficult airway management set including laryngeal mask airway, intubating laryngeal mask airway, fiberoptic bronchos-copy and transcutaneous tracheotomy set. And most important is preliminary evaluation of airway and cautious planning of tracheal intubation.
舌扁桃体增生较为罕见，但可能导致气管插管困难或无法插管。我们遇到了两例因舌扁桃体增生而行气管插管的病例。一名71岁男性计划对有症状的肥大舌扁桃体进行切除和活检。在该患者中，由于左侧肥大的舌扁桃体比右侧的小，我们从左侧口角通过硬质喉镜进行了经口气管插管。一名44岁男性在患舌扁桃体炎后计划切除有症状的肥大舌扁桃体。在该患者中，我们在抬起下颌和伸展舌头的辅助下，使用纤维支气管镜进行了经鼻气管插管。当麻醉医生能够预测舌扁桃体异常时，对于困难气道和插管可能推荐这些方法。然而，有必要准备包括喉罩气道、插管型喉罩气道、纤维支气管镜和经皮气管切开套件在内的困难气道管理设备。而且最重要的是对气道进行初步评估并谨慎规划气管插管。
