Anticipated Difficult Intubation Due to Polypoidal Squamous Cell Carcinoma on Posterior One Third of Tongue.
The most common type of tongue malignancy is squamous cell carcinoma which constitutes about 36.5% of all oral malignancies. It usually presents as painless swelling which is often
ignored by the patient until late when it is symptomatic because of demonstrable growth in the oral cavity.
Airway management in carcinoma posterior one third of tongue is always a concern to the anaesthesiologist due to possibility of trauma, bleeding, dislodgement of fractured tissue, chances of aspiration, difficulty in mask ventilation following induction of anaesthesia and compromised airway consequent to difficulty during laryngoscopy and intubation.
A 32-years-old, ASA grade I, female patient, regular tobacco chewer, presented with recurrent and gradually progressive
intraoral polypoidal growth on right side of base of tongue. She was posted for excisional biopsy under general anaesthesia.
Airway examination revealed adequate mouth opening with Mallampati grade II. The growth was obliterating the tonsillar fauces and pillars on right side but uvula and soft palate were clearly visible on phonation.
Findings of swelling were confirmed by magnetic resonance imaging and computed tomography scan neck
which showed polypoidal exophytic lesion at the base of posterior part of tongue in pre epiglottic space measuring 33x23x35 mm with separation of epiglottis from the growth involving right vallecula.
Res Pract Anesthesiol Open J. 2018; 3(1): 13-14. doi: 10.17140/RPAOJ-3-118