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Anesth Analg 2005;100:1210-1213
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000146434.36989.34

GENERAL ARTICLES

The Chewing of Betel Quid and Oral Submucous Fibrosis and Anesthesia

Naveen Eipe, MD

Department of Anesthesia, Padhar Hospital, Padhar, Madhya Pradesh, India

Address correspondence and reprint requests to Naveen Eipe, MD, Chief Anesthetist, Padhar Hospital, Padhar. Betul, Madhya Pradesh- 460005. India. Address e-mail to neipe{at}yahoo.com.

Oral submucous fibrosis (OSMF) is a premalignant lesion of the buccal mucosa caused by chewing betel quid. It results in progressive inability to open the mouth. OSMF causes difficulty in laryngoscopy and intubation of the trachea. Patients with OSMF require anesthesia for trismus correction, resection, and reconstructive (oncoplastic) surgery for coexisting oral malignancies or other unrelated surgeries. Our review of the anesthetics of 44 patients with oral malignancies suggested that 8 had OSMF. The preoperative airway assessment, including the Mallampati score and the clinical Tumor Node Metastasis stage, were useful in predicting the need for fiberoptic intubation. Patients with oral malignancies and OSMF had increased requirement for fiberoptic endotracheal intubations (62.5%) compared with those without OSMF (44.4%). Three different techniques of airway management (tracheal intubation after direct laryngoscopy, fiberoptic tracheal intubation, and tracheostomy) in four patients with OSMF are described. OSMF contributes to the development of the malignancy, delays the diagnoses, and complicates the anesthetic management.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.