Airway Management Challenges During General Anesthesia in a Patient With a Large Lingual Cavernous Hemangioma: A Case Report

TL;DR

This case report describes successful airway management during surgery for a patient with a large lingual hemangioma.

Contribution

It highlights a successful anesthetic strategy using a video laryngoscope for patients with oral hemangiomas.

Findings

A video laryngoscope facilitated safe intubation in a patient with a large lingual cavernous hemangioma.

The patient underwent successful surgery and recovery without complications from the hemangioma.

Strategic airway management minimized the need for invasive airway techniques in this case.

Abstract

The induction of general anesthesia in patients with airway compromise poses significant challenges, particularly in the presence of oral vascular tumors like hemangiomas, which are benign but can lead to substantial bleeding. This case study discusses an 82-year-old woman with endometrial carcinoma scheduled for elective total hysterectomy with bilateral salpingo-oophorectomy. Preoperative evaluation revealed a large lingual cavernous hemangioma. Key anesthetic considerations included difficulties with mask ventilation and intubation, bleeding from the hemangioma, and the risk of blood aspiration. However, the induction of anesthesia, along with mask ventilation and intubation facilitated by a video laryngoscope, was executed without complications, leading to successful extubation. On the fifth postoperative day, the patient was discharged following an uncomplicated recovery. A comprehensive airway management strategy for patients with oral cavity hemangioma enables successful intubation and general anesthesia while minimizing the necessity for invasive or rescue airway methods, underscoring the importance of strategic airway management in these scenarios.

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