Airway obstruction following mandibular surgery—a case report

Abstract

Upper airway obstruction may be due to loss of muscle tone of the upper airway, with mechanical obstruction from the tongue, or foreign bodies such as teeth, dentures, secretions or tumours present in the airway. Loss of skeletal muscle tone of the upper airway is related to the inhibition of the gamma motor neuron system, which results in relaxation of the tongue and pharyngeal constrictor muscles. At the level of the oral passage in the supine position, obstruction is usually as a result of the tongue falling back, at the level of the soft and partially the hard palate. Rarely, does the tongue fall into the pharynx. At the level of the pharynx, two mechanisms of obstruction may operate, which are independent of the position or movement of the tongue. It is due to the base of the epiglottis coming close to the rima glottidis, and the lateral parts of the epiglottis coming into contact with the posterior pharyngeal wall.