Massive tongue swelling as a complication after spinal surgery.

We report four cases of massive tongue swelling after spinal surgery. Swelling resulted from the position of the spine during surgery (flexed thoracic-cervical position), fixation of the endotracheal tube, additional surgical gauzes packed around the endotracheal tube, and compression of the base of the tongue. Swelling, which causes obstruction of the airway, is a severe complication after spinal surgery that sometimes requires a tracheotomy. This complication can be avoided by careful positioning of the patient and by fixation of the endotracheal tube before surgery. Once swelling of the tongue occurs, administration of a corticosteroid is effective in preventing construction of the airway.