Awake endotracheal intubation using a video-assisted intubating stylet in a patient with a large supraglottic mass: A case report

Jun, Joo Hyun; Kim, Jin Kyoung; Lee, Eun Ji

doi:2015.10.3.219

Anesth Pain Med > Volume 10(3); 2015 > Article

Case Report

General Article

Anesthesia and Pain Medicine 2015;10(3):219-222.
DOI: https://doi.org/10.17085/apm.2015.10.3.219 Published online July 31, 2015.

Awake endotracheal intubation using a video-assisted intubating stylet in a patient with a large supraglottic mass: A case report

Joo Hyun Jun, Jin Kyoung Kim, Eun Ji Lee

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jkane.kim@samsung.com

Received: 24 October 2014 • Revised: 21 November 2014 • Accepted: 10 December 2014

Abstract

A 70-year-old man was scheduled for laryngeal microsurgery for supraglottic tumor. A preoperative indirect laryngoscopy demonstrated a large tumor obstructing the most of glottic opening. To prevent damage to the tumor during advancement of the endotracheal tube (ETT), an awake intubation assisted by Clarus Video System (CVS), was planned. Ten percent lidocaine spray was applied to the oropharynx. After sufficient preoxygenation, the patient was lightly sedated with continuous remifentanil and propofol infusion. The CVS, loaded with an ETT (inner diameter of 5.5 mm), was inserted orally by the anesthesiologist. The tube was carefully slid off the stylet into the glottic opening under direct vision. The anesthesiologist also confirmed that there was no damage to the tumor during intubation.

Key Words: Awake intubation, Supraglottic mass, Video assisted intubating stylet