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

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.