Simple injection of air proves successful in releasing child's tongue trapped in bottle, inspired by opening a wine bottle

October 31, 2019

A relatively simple injection of air has proved successful in releasing a 7-year-old boy's tongue that became entrapped in a juice bottle, says new research published in the latest edition of the European Journal of Anaesthesiology (the official journal of the European Society of Anaesthesiology).

The technique, inspired by the author's memory of opening a wine bottle with a similar method, means other more complex techniques involving general anaesthesia and physically cutting off the bottle from around the tongue can be avoided. The report is by Professor Christoph Eich and Dr Simone Arndt, Auf der Bult Children's Hospital, Hannover, Germany.

Tongue entrapment in a bottle is a relatively rare emergency that usually involves children of school age who are playing with bottles using their tongue, unaware of the risk of their tongue becoming stuck. Strangulation of the front part of the tongue within the bottle neck causes accumulation of fluid (oedema), restriction of blood flow (ischaemia), capillary damage, and pain; this may put the child's upper airway and breathing at risk.

Some authors have reported management under local anaesthesia, systemic pain relief, or sedation; others have described the use of general anaesthesia and even endoscopic intubation. Several reports have described non-invasive attempts to free an entrapped tongue.

However, similar to this new case, generous lubrication followed by rotation of the bottle and pulling it were unsuccessful in all but one case, as was the release of a presumed vacuum by cutting off the bottom of the bottle or drilling holes in the bottle wall. In most cases, the bottles (glass, plastic, or metal) were physically cut.

All reported children had a severely swollen tongue after liberation from the bottle neck as well as signs of ischaemia and capillary damage. One child had to be intubated because of upper airway obstruction after the bottle was removed and remained ventilated for two days. Eventually, all children made full recoveries.

In this case reported by Eich and Arndt, the 7-year-old boy from Hannover, Germany, had been drinking juice from the bottle, and had been licking inside the bottle to try and get the last drops of the juice from it. Suddenly, the boys tongue became trapped, and his mother could not remove it. On arrival at Hannover's Auf der Bult Children's Hospital, the boy was in mild distress and showed drooling but had an open airway and no apparent shortness of breath.

Under light intravenous sedation with midazolam and esketamine, a thin 70 mm plastic button cannula was carefully advanced between the tongue and the bottle neck, with the intent to release a presumed vacuum inside the bottle. This had no effect.

Subsequently, the cannula was connected to a combination of IV extension tubing and a 20 ml syringe. Air was then injected into the bottle, and after 60 ml of air, the swollen and discoloured tongue squeezed out of the bottle neck - slowly at first and then swiftly. To help reduce the swelling, prednisolone and ibuprofen were given and the boy was admitted to a paediatric surgical ward for a 24-hr observation period. On discharge, the swelling had largely dissipated but for about three days the front part of the tongue remained very discoloured. At follow-up 14 days after the entrapment, the boy had fully recovered (see pics below).

Professor Eich says: "We found only one previous report of a positive pressure technique similar to the one used by us in our patient. Published over 30 years ago, it obviously had largely been forgotten. In our case, the idea to attempt to inject air into the bottle to produce positive pressure was inspired by my personal recollection of successfully uncorking a wine bottle while working as an anaesthetic registrar, with the use of a syringe-and-cannula technique on an occasion when no corkscrew was available!"

He concludes: "Use of positive pressure proved to be a simple, effective, and safe technique for releasing a tongue entrapped in a bottle. We would suggest trying this method before more invasive procedures under general anaesthesia are considered."

ESA (European Society of Anaesthesiology)

Related Tongue Articles from Brightsurf:

Silicone surface mimics topology, wettability of a real human tongue
The tongue helps people taste food, but structures on its surface also help them sense textures -- something that's also very important when savoring a meal.

Earliest example of a rapid-fire tongue found in 'weird and wonderful' extinct amphibians
Fossils of bizarre, armored amphibians known as albanerpetontids provide the oldest evidence of a slingshot-style tongue, a new Science study shows.

3D printing the first ever biomimetic tongue surface
Scientists have created synthetic soft surfaces with tongue-like textures for the first time using 3D printing, opening new possibilities for testing oral processing properties of food, nutritional technologies, pharmaceutics and dry mouth therapies.

Sensory device stimulates ears and tongue to treat tinnitus in large trial
A device that stimulates the ears and tongue substantially reduced the severity of tinnitus symptoms in 326 patients for as long as 1 year, while achieving high patient satisfaction and adherence.

What happens when food first touches your tongue
A new study might explain why humans register some tastes more quickly than others, potentially due to each flavor's molecular size.

Tongue microbes provide window to heart health
Microorganisms on the tongue could help diagnose heart failure, according to research presented today on HFA Discoveries, a scientific platform of the European Society of Cardiology (ESC).

An artificial 'tongue' of gold to taste maple syrup
A chemistry professor at Université de Montréal has developed a new test using gold nanoparticles to establish the flavour profile of maple syrup and help producers evaluate its quality.

Images reveal how bacteria form communities on the human tongue
Using a recently developed fluorescent imaging technique, researchers in the United States have developed high-resolution maps of microbial communities on the human tongue.

Losing tongue fat improves sleep apnea
Using magnetic resonance imaging (MRI) to measure the effect of weight loss on the upper airway in obese patients, researchers found that reducing tongue fat is a primary factor in lessening the severity of OSA.

Be aware of potential complications following tongue-tie surgery in babies
Complications following a procedure to treat tongue-tie in babies are occurring that can result in admission to hospital, something a University of Otago paediatrician says needs to be better understood by both health practitioners and parents.

Read More: Tongue News and Tongue Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to