The two stage flexible fiberoptic bronchoscoptic awake intubation in a patient with the symptomatic vallecular cyst: A case report

Chung, Mee Young; Kim, Chang Jae; Chea, Jun Seuk; Lee, Myung No; Lee, Byung Ho

Case Report

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. bhlee@catholic.ac.kr

Abstract

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