RESEARCH ARTICLE


Unexpected Difficult Intubation in a Patient with Prominent Mandibular Tori



Jaydev Sarma
Harvard Medical School, Staff Anesthesiologist, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.


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Creative Commons License
© 2014 Sarma

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Harvard Medical School, Staff Anesthesiologist, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Tel: 617 724 7182; Cell: 508 463 7918; Fax: 617 643 4040; E-mail: jsarma@partners.org


Abstract

Bony exostoses such as mandibular tori are fairly common. They are asymptomatic, benign cortical bony protuberances occurring along the lingular aspect of the mandible. Large tori may interfere with direct laryngoscopy resulting in difficult intubation. This is a case report about a 66 year old, Caucasian male with a Mallampati class I airway who was un-intubatable initially, due to the presence of bilateral mandibular tori that formed a plate of bone beneath his tongue. He was intubated subsequently with the help of an Eschmann bougie.

Keywords: Difficult intubation, mandibular tori, palatal tori, torus palatinus.