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- DOI 10.18231/j.ijca.2025.085
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Anaesthetic management of a large parapharyngeal mass using electromyography monitoring
Managing parapharyngeal space tumours presents significant anesthetic challenges, particularly with airway access and the risk of neurovascular injury. A large pleomorphic adenoma extending into the parapharyngeal space was successfully excised via a transcervical mandibulectomy approach. Due to the anticipated difficulty in airway management, awake fiberoptic intubation was performed to ensure patient safety. Anaesthesia was maintained without neuromuscular relaxants using target-controlled infusions of propofol and fentanyl, allowing continuous neuromonitoring. Intraoperative nerve preservation was facilitated by electromyography (EMG) monitoring using an EMG endotracheal tube, which aided in the identification and protection of critical neural structures. Postoperative examination revealed normal vocal cord mobility with no signs of edema or nerve injury. The recovery period was uneventful, and the patient was discharged after 10 days. Follow-up at two months confirmed the absence of delayed nerve palsies, demonstrating a successful anaesthetic and surgical outcome.
Keywords: Electromyography, Pleomorphic adenoma, Airway management, Intraoperative nerve monitoring.
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How to Cite This Article
Vancouver
Ramalakshmi G, Gayathri B, Yerramilli P, Kanthan K. Anaesthetic management of a large parapharyngeal mass using electromyography monitoring [Internet]. Indian J Clin Anaesth. 2025 [cited 2025 Oct 02];12(3):545-547. Available from: https://doi.org/10.18231/j.ijca.2025.085
APA
Ramalakshmi, G., Gayathri, B., Yerramilli, P., Kanthan, K. (2025). Anaesthetic management of a large parapharyngeal mass using electromyography monitoring. Indian J Clin Anaesth, 12(3), 545-547. https://doi.org/10.18231/j.ijca.2025.085
MLA
Ramalakshmi, Geetha, Gayathri, Balasubramaniam, Yerramilli, Pranati, Kanthan, Karthik. "Anaesthetic management of a large parapharyngeal mass using electromyography monitoring." Indian J Clin Anaesth, vol. 12, no. 3, 2025, pp. 545-547. https://doi.org/10.18231/j.ijca.2025.085
Chicago
Ramalakshmi, G., Gayathri, B., Yerramilli, P., Kanthan, K.. "Anaesthetic management of a large parapharyngeal mass using electromyography monitoring." Indian J Clin Anaesth 12, no. 3 (2025): 545-547. https://doi.org/10.18231/j.ijca.2025.085