Base of Tongue Non-Hodgkin’s Lymphoma: Difficult Intubation

Base of Tongue Non-Hodgkin’s Lymphoma: Difficult Intubation

Author Info

Corresponding Author
Hazem Kafrouni
Department of Anesthesiology, Anesthesia and Pain Management, Faculty of Medicine and Medical Sciences, Saint George Hospital University Medical Center in association with Saint George Faculty of Postgraduate Medical Education, University of Balamand, Beirut, Lebanon


Primary Non-Hodgkin’s Lymphoma (NHL) of the tongue is a very rare tumor most commonly affecting elderly patients causing upper airway obstruction and anticipated difficult intubations with space occupying lesions that prevent tongue displacement and hence, scarce space for laryngoscopy. A 78-year-old man presented with progressive stridor and dyspnea. Oral examinations revealed tongue asymmetry and friable ulcerative lesions. During induction of anaesthesia in a scheduled partial glossectomy, difficult nasotracheal intubation was encountered despite using the Glidescope. Laryngeal landmarks could not be identified but successful nasotracheal intubation by hand-assisted and magill forceps manipulation of the endotracheal tube direction under video laryngoscopy. Failed intubation should always be considered in the management of base of tongue tumors. Pre-operative assessment and planning to secure the airway in patients presenting with base of tongue tumors decreases morbidity and mortality, especially when an emergency plan is prepared. No single airway management technique can be used for every patient. Further research is required for guiding the choice of airway management in such patients.

Article Info

Article Type
Case Report
Publication history
Received: Fri 19, Mar 2021
Accepted: Thu 19, Aug 2021
Published: Tue 31, Aug 2021
© 2021 Hazem Kafrouni. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.
DOI: 10.31487/j.SCR.2021.08.12