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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2011;6(2):146-149.
Published online April 30, 2011.
The two stage flexible fiberoptic bronchoscoptic awake intubation in a patient with the symptomatic vallecular cyst: A case report
Mee Young Chung, Chang Jae Kim, Jun Seuk Chea, Myung No Lee, Byung Ho Lee
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Large symptomatic vallecular cyst is rare, but may cause difficulty or inability in conventional tracheal intubation during induction of general anesthesia. A flexible fiberoptic bronchoscope is the most useful general purpose aid to awake intubation in the patient with a known difficult airway. We experienced a case of flexible video image fiberoptic bronchoscopic awake orotracheal intubation in a patient with the large symptomatic vallecular cyst. A 35-year-old male suffered from foreign body sensation, voice change and dyspnea one month after upper respiratory tract infection. The two step flexible fiberoptic bronchoscopic approach was performed in the management of a known difficult intubation due to a vallecular cyst. We had an uneventful general anesthesia for removal of large symptomatic vallecular cyst because we anticipated difficult intubation.
Key Words: Difficult intubation, Flexible fiberoptic bronchoscope, Vallecular cyst

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