Palatopharyngeal wall perforation during GlideScope® intubation

We report a case of palatopharyngeal wall perforation during intubation with a GlideScope laryngoscope. The likely mechanism was advancing and rotating the endotracheal tube against a taut palatopharyngeal fold. This was missed during the initial laryngoscopy, because there is a potential blind-spot...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2008-11, Vol.36 (6), p.870-874
Main Authors: LEONG, W. L, LIM, Y, SIA, A. T. H
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Care and treatment
Case studies
Colposcopes
Diagnosis
Endoscopes
Female
Gastroscopes
Health aspects
Humans
Intubation, Intratracheal - adverse effects
Intubation, Intratracheal - instrumentation
Laryngoscopes - adverse effects
Medical sciences
Middle Aged
Palate - injuries
Patient outcomes
Pharynx - injuries
Uterine cancer
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Summary:We report a case of palatopharyngeal wall perforation during intubation with a GlideScope laryngoscope. The likely mechanism was advancing and rotating the endotracheal tube against a taut palatopharyngeal fold. This was missed during the initial laryngoscopy, because there is a potential blind-spot in the oropharynx when attention is focused on the GlideScope" monitor Fortunately, there were no sequelae other than minor bleeding and a mild sore throat and no surgical intervention was necessary. The use of unnecessary force during the endotracheal tube insertion, the use of too large a laryngoscope blade and the use of a rigid stylet could possibly also have been contributory factors to this complication.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057x0803600620