Case report: osteonecrosis of the mandible after laryngoscopy and endotracheal tube placement

Anesth Analg. 2010 Aug;111(2):437-41. doi: 10.1213/ANE.0b013e3181e0cdcd. Epub 2010 May 21.

Abstract

Four patients underwent laryngoscopy and general anesthesia surgery without apparent perioperative complications. Within days of their procedure, throat and mouth pain were reported and intraoral examination in all cases revealed exposed bone in the posterior mandible. The sequestra were easily removed and healing was uneventful. These lesions are likely associated with localized oral trauma during intubation causing periosteal damage, compromised blood supply, and subsequent bone necrosis. Because trauma to the mylohyoid ridge during intubation is likely more common than previously appreciated, anesthesiologists should be aware of this potential complication and refer patients to a specialist for management.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Infective Agents, Local / therapeutic use
  • Chest Tubes
  • Female
  • Humans
  • Intubation, Intratracheal / adverse effects*
  • Intubation, Intratracheal / instrumentation
  • Laryngoscopy / adverse effects*
  • Male
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Diseases / etiology*
  • Mandibular Diseases / physiopathology
  • Mandibular Diseases / therapy
  • Middle Aged
  • Mouthwashes / therapeutic use
  • Osteonecrosis / diagnostic imaging
  • Osteonecrosis / etiology*
  • Osteonecrosis / physiopathology
  • Osteonecrosis / therapy
  • Pain Measurement
  • Pain, Postoperative / etiology
  • Radiography
  • Time Factors
  • Treatment Outcome
  • Wound Healing

Substances

  • Anti-Infective Agents, Local
  • Mouthwashes