Awake fiberoptic intubation in a patient with lingual hematoma

Abstract EN

Lingual hematoma is a known complication of uncontrolled seizures.

The tongue, being an extremely vascular structure, sometimes enlarges to such an extent that it may occupy the entire oral cavity resulting in airway obstruction.

We present a case of lingual hematoma in a fifty-eight-year-old patient due to a tongue bite.

Due to the concern that subsequent bite might lead to further lingual enlargement which might compromise the airway, it was decided to secure the airway prophylactically.

Awake nasal fiberoptic intubation was performed after adequate topical anesthesia as there was no oral access due to the enlarged tongue.

Sedatives were avoided due to risk of possible airway loss.

We believe that awake nasal fiberoptic intubation with only topical anesthesia and avoiding sedatives is a useful technique in patients with a high-risk of airway loss.