Managing a difficult airway due to supraglottic masses: successful videolaryngoscopic intubation after induction of general anesthesia

Abstract

Abstract Background Awake fiberoptic intubation is regarded as the gold standard for managing anticipated difficult airways. However, it may not be feasible in patients with supraglottic masses.Case presentation A 41-year-old female patient was scheduled for excision of bilateral, mobile, and pedunculated masses on both aryepiglottic folds, which covered almost the entire upper part of the glottis. Considering her symptoms (neither stridor nor dyspnea in any position) and the risks of awake fiberoptic intubation in this patient (bleeding, damage, and displacement of the masses), the initial decision was to proceed with gentle tracheal intubation using a videolaryngoscope under general anesthesia. Ensuring that mask ventilation was maintained with ease, the patient was sequentially administered intravenous propofol, remifentanil, and rocuronium. Under sufficient depth of anesthesia, intubation using a videolaryngoscope was successfully performed without any complications.Conclusions Videolaryngoscopic intubation after induction of general anesthesia can be a feasible alternative for managing difficult airways in patients with supraglottic masses.