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Anesth Analg 2007;105:786-787
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000275180.22135.7f

GENERAL ARTICLES

Easy Endotracheal Intubation of a Patient Suffering from Both Cushing's and Nelson's Syndromes Predicted by the Upper Lip Bite Test Despite a Mallampati Class 4 Airway

Zahid Hussain Khan, MD, Mahin Gharabaghian, MD, Ferozeh Nilli, MD, Mehdi Ghiamat, MD, and Mostafa Mohammadi, MD

From the Department of Anesthesiology, School of Medicine, Medical Sciences/University of Tehran, Imam Khomeni Medical Center, Tehran, Iran.

Address correspondence and reprint requests to Zahid Hussain Khan, MD, Department of Anesthesiology, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Keshavarz Blvd., Tehran 14197, Iran. Address e-mail to khanhzh51{at}yahoo.com.

A 31-yr-old woman with concurrent Cushing's and Nelson's syndromes was scheduled for transsphenoidal hypophysectomy. The patient had generalized edema, morbid obesity, and a history of sleep apnea. Her Mallampati assessment was Class 4, suggesting very difficult intubation, but the upper lip bite test predicted easy intubation. After rapid sequence induction, there was a Class 1 view on laryngoscopy, and intubation was accomplished easily.




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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 © 2007 by the International Anesthesia Research Society.