Uvular trauma caused by endotracheal tube
General anaesthesia is a very rare cause of injury to uvula and the authors present one such a case, published in the Journal of Neuroanaesthesiology and Critical Care.

A 25-year-old male, a diagnosed case of right temporal glioma, underwent right temporal craniotomy and tumour excision at our institute. He had no significant past medical history, was a non-smoker and there was no history of recent upper respiratory tract infection. His airway was graded to be Mallampati Class I during pre-anaesthetic check-up.

In the operation theatre, tracheal intubation was done using a size #4 Macintosh laryngoscope blade and an 8.5 mm (ID) cuffed endotracheal tube. Intubation was smooth and achieved in the first attempt. The intra-operative period was uneventful. In the post-operative period, he was electively ventilated till the next morning, in the Intensive Care Unit (ICU). The patient was extubated after ascertaining the criteria for extubation, following which he complained of throat discomfort.

He was given steam inhalation, and he further complained of foreign body sensation in the throat along with difficulty in swallowing. Examination of the throat using a laryngoscope revealed a congested, swollen and elongated uvula with a necrosed tip. The patient was reviewed by a laryngologist, who considered the possibility of a uvulitis due to trauma induced by endotracheal tube.

The patient was advised for intravenous injections of antibiotics such as ceftriaxone and amikacin along with saline gargles, steam inhalation and gargles of viscous lignocaine intermittently.

The patient continued this treatment and the symptoms slowly abated with more than 50% recovery on day 4. By the time he was discharged on day 7, his symptoms had almost completely resolved. Examination of the throat revealed normal-sized uvula with minimal congestion and no ulceration.

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