Education  |   March 2018
Images in Anesthesiology: Intraoral Lipomas
Author Notes
  • From the Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.
  • Charles D. Collard, M.D., served as Handling Editor for this article.
    Charles D. Collard, M.D., served as Handling Editor for this article.×
  • Address correspondence to Dr. Ferschl: marla.ferschl@ucsf.edu
Article Information
Education / Images in Anesthesiology / Airway Management / Gastrointestinal and Hepatic Systems / Respiratory System
Education   |   March 2018
Images in Anesthesiology: Intraoral Lipomas
Anesthesiology 3 2018, Vol.128, 636. doi:10.1097/ALN.0000000000001928
Anesthesiology 3 2018, Vol.128, 636. doi:10.1097/ALN.0000000000001928
INTRAORAL lipomas can cause significant airway obstruction and lead to respiratory compromise. Additionally, they can grossly alter airway anatomy, making direct laryngoscopy challenging.1  Oropharyngeal lipomas arising from the posterior pharynx or supraglottic region may present particular challenges for the anesthesiologist, given that they are not always obvious on preoperative evaluation.
This image shows an intraoral lipoma in a 9-day-old term neonate with a normal preoperative examination who underwent an uncomplicated general anesthetic with a supraglottic airway for magnetic resonance imaging. Following the anesthetic, stridor was noted and a bedside fiberoptic bronchoscopy identified intraoral lipomas. We hypothesize that the new onset stridor was due to the effect of residual anesthetic agent, causing increased pharyngeal collapsing forces and reduced neural compensation resulting in airway obstruction.2  The airway was subsequently secured with an awake nasal fiberoptic intubation.
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