Skip to main content
  • Home
  • Articles
    • Archive from 2022 July
    • Archive 1960 to 2022 June
    • Accepted Articles
    • Published Ahead-of-Print
    • Supplement
  • About
  • For Authors
  • Podcasts

Acute unilateral submandibular gland swelling associated with the laryngeal mask airway

< Back to Listing

Share this Article

Singapore Med J 2013; 54(12): e236-e239; http://dx.doi.org/10.11622/smedj.2013248
Acute unilateral submandibular gland swelling associated with the laryngeal mask airway

  • Abstract
  • PDF
  • References

Suhitharan T, Seevanayagam S, Parker FC, Teoh WH
Correspondence: Dr Suhitharan Thangavelautham, tsuhitharan@yahoo.com
 

ABSTRACT
We describe a rare complication of acute unilateral submandibular gland swelling following the use of laryngeal mask airway (LMA) in two patients with otherwise uneventful perioperative airway management. This is likely to be a consequence of the pressure exerted by the airway cuff on the tissues within the submandibular triangle. As this complication is rarely reported, its true incidence may in fact be higher, suggesting a need for greater attention on LMA cuff pressures and degree of cuff inflation. We discuss the presenting clinical features, pathophysiology and utilisation of ultrasonographic confirmation of sialadenopathy, and review the current anaesthetic literature to raise awareness of this unusual and under-reported complication of LMA. This complication can be mitigated by incorporating routine manometric checks and limiting intracuff pressures to < 60 cmH2O, potentially avoiding LMA insertions in patients with sialolithiasis and avoiding the use of nitrous oxide.

Keywords: laryngeal mask airway, salivary gland, sialadenopathy, submandibular gland swelling, ultrasonography
Singapore Med J 2013; 54(12): e236-e239; http://dx.doi.org/10.11622/smedj.2013248
http://smj.org.sg/sites/default/files/5412/5412cr1.pdf

REFERENCES

1. Teoh WH, Lee KM, Suhitharan T, et al. Comparison of the LMA Supreme vs the i-gel in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation. Anaesthesia 2010; 65:1173-9.
http://dx.doi.org/10.1111/j.1365-2044.2010.06534.x
 
2. Nagai K, Sakuramoto C, Goto F. Unilateral hypoglossal nerve paralysis following the use of the laryngeal mask airway. Anaesthesia 1994; 49:603-4.
http://dx.doi.org/10.1111/j.1365-2044.1994.tb14230.x
 
3. Brimacombe J, Keller C. Salivary gland swelling and lingual nerve injury with the ProSeal laryngeal mask airway. Eur J Anaesthesiol 2005; 22:954-5.
http://dx.doi.org/10.1017/S0265021505241637
 
4. Hanumanthaiah D, Masud S, Ranganath A. Inferior alveolar nerve injury with laryngeal mask airway: a case report. J Med Case Rep 2011; 5:122.
http://dx.doi.org/10.1186/1752-1947-5-122
 
5. Hooda S, Gupta SK. Acute transient sialadenopathy associated with laryngeal mask airway. Anesth Analg 1998; 87:1438-40.
 
6. Kawaguchi M, Sakamoto T, Ohnishi H, Karasawa J. Pharyngeal packs can cause massive swelling of the tongue after neurosurgical procedures. Anesthesiology 1995; 83:434-5.
http://dx.doi.org/10.1097/00000542-199508000-00037
 
7. Quinn ME, Quinn TD, Mian AZ, Sakai O. Imaging findings of "anesthesia mumps" (acute postoperative sialadenitis) after general anesthesia. J Comput Assist Tomogr 2012; 36:745-8.
http://dx.doi.org/10.1097/RCT.0b013e318268ec47
 
8. Attas M, Sabawala PB, Keats AS. Acute transient sialadenopathy during induction of anesthesia. Anesthesiology 1968; 29:1050-2.
http://dx.doi.org/10.1097/00000542-196809000-00036
 
9. Gupta R. Unilateral transient sialadenopathy: another complication of oropharyngeal airway. Anesthesiology 1998; 88:551-2.
http://dx.doi.org/10.1097/00000542-199802000-00046
 
10. Moore KL. Salivary glands. In: Paul J Kelly, ed. Clinically Oriented Anatomy. Baltimore: Lippincott, Williams &Wilkins, 1992; 948-9.
 
11. Ogata J, Minami K, Oishi M, Tamura H, Shigematsu A. The influence of the laryngeal mask airway on the shape of the submandibular gland. Anesth Analg 2001; 93:1069-72.
http://dx.doi.org/10.1097/00000539-200110000-00054
 
12. Brimacombe J, Keller C. A comparison of pharyngeal mucosal pressure and airway sealing pressure with the laryngeal mask airway in anesthetized adult patients. Anesth Analg 1998; 87:1379-82.
 
13. Seet E, Yousaf F, Gupta S, et al. Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology 2010; 112:652-7.
http://dx.doi.org/10.1097/ALN.0b013e3181cf4346
 
14. Levitan RM, Kinkle WC. Initial anatomic investigations of the I-gel airway: a novel supraglottic airway without inflatable cuff. Anaesthesia 2005; 60:1022-6.
http://dx.doi.org/10.1111/j.1365-2044.2005.04258.x
 
15. Keijzer C, Buitelaar DR, Efthymiou KM, et al. A comparison of postoperative throat and neck complaints after the use of the i-gel and the La Premiere disposable laryngeal mask: a double-blinded, randomized, controlled trial. Anesth Analg 2009; 109:1092-5.
http://dx.doi.org/10.1213/ANE.0b013e3181b6496a
 
16. Lumb AB, Wrigley MW. The effect of nitrous oxide on laryngeal mask cuff pressure. In vitro and in vivo studies. Anaesthesia 1992; 47:320-3.
http://dx.doi.org/10.1111/j.1365-2044.1992.tb02173.x
 
17. Marchal F, Dulguerov P. Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg 2003; 129:951-6.
http://dx.doi.org/10.1001/archotol.129.9.951
 
18. Yoshimura Y, Inoue Y, Odagawa T. Sonographic examination of sialolithiasis. J Oral Maxillofac Surg 1989; 47:907-12.
http://dx.doi.org/10.1016/0278-2391(89)90372-8
×

Around the Site

Home

About SMJ

For Reviewers

Sign Up for Alerts

Issues

Current Issue

All Issues

Online First

Supplement

CME

For Authors

Instructions for Authors

Submit Manuscript


Follow us on:
        

More Links

Contact Us

Copyright

Advertise

SMJ Forms

Privacy Policy

SMA Home

Copyright 2021. Singapore Medical Association. All Rights Reserved.