Anesthesia mumps with airway obstruction after radical nephrectomy: A case report and literature review

Wanqiang Li; Zhengquan Liao; Ling Yao; Lusheng Zhang; Xuesong Li; Ziqiang Dong

doi:10.3389/fsurg.2022.1039362

Anesthesia mumps with airway obstruction after radical nephrectomy: A case report and literature review

Front Surg. 2023 Jan 6:9:1039362. doi: 10.3389/fsurg.2022.1039362. eCollection 2022.

Authors

Wanqiang Li¹, Zhengquan Liao², Ling Yao³, Lusheng Zhang¹, Xuesong Li⁴, Ziqiang Dong¹

Affiliations

¹ Department of Urology, the First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, China.
² Department of Urology, Yidu People's Hospital, Yichang, China.
³ Department of Intensive Care Unit, the First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, China.
⁴ Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.

Abstract

Anesthesia mumps have rarely been reported. This article presents the diagnosis and treatment of a case of anesthesia mumps with airway obstruction in the urology department and reviews previous cases of the disease. A 58-year-old man had a history of hypertension and diabetes, and his blood pressure and glucose levels were well controlled. He underwent laparoscopic radical nephrectomy for a right renal tumor. Postoperatively, a swelling of approximately 5 × 4 cm was observed in the left parotid region and left eyelid, no palpable crepitation was detected, and the skin overlying the left parotid gland was mildly hyperemic and tender. Enhanced computed tomography of the head and neck revealed obvious swelling of the laryngopharyngeal airway, and electronic laryngoscopy showed narrow airway. Laboratory test results including white blood cell count, C-reactive protein, serum amylase, and lipase levels were normal. Glycosylated hemoglobin level was 6.8%, and the salivary culture from Stensen's duct was negative. The patient was managed with endotracheal intubation and a ventilator to maintain breathing along with anti-infection, expectorant, and symptomatic treatment. The swelling in the left parotid gland gradually resolved without recurrence, and the patient was extubated on the 7th postoperative day. In this case, the pathophysiology of anesthesia mumps may have been related to the incorrect positioning of the thick short neck and the use of a head ring, which can result in the squeezing of vessels. In most cases, the salivary gland swelling resolves with observation and symptomatic treatment. In patients with anesthesia mumps, emergency airway management and careful observation are necessary if upper airway obstruction occurs. This case report should increase awareness of anesthesia mumps and its complications among anesthesiologists, surgeons, and postoperative caregivers.

Keywords: airway obstruction; anesthesia mumps; postoperative care; radical nephrectomy; sialadenitis.