DOI: 10.36347/sasjm.2016.v02i05.006

Pages: Page: 118-120

Preoperative airway examination revealed non-specific finding in a 38-year-old woman (height 163 cm, weight 110.2 kg). After anesthesia induction, direct laryngoscopy showed enlarged and uneven tissues at the base of the tongue and pharynx. The initial intubation attempt failed. The attending anesthesiologist identified huge lingual tonsil and attempted to find the tip of the epiglottis. After three attempts and fails, we awakened her. Indirect laryngoscopic examination showed that she had significant lingual tonsil hyperplasia (LTH) and the tip of the epiglottis was identified in the lingual tonsil tissue. Although lingual tonsil, supraepiglottic mass, often overlooked, LTH can cause difficult intubation. Anesthesiologists should be aware of the possibility of LTH and prepare for the difficult intubation by high suspicion and proper airway examination