Successful fiberoptic orotracheal intubation by lifting large thyroid mass and tongue protrusion in left lateral position: a case report

Abstract

Introduction: Awake fiberoptic bronchoscopy has long been considered the criterion standard for the management of difficult airways because of large thyroid malignancies. After an unsuccessful attempt to intubate with a fiberoptic bronchoscope in the supine position, the decision to switch to the left lateral position was made. We present this case to propose the utilization of the lateral position for awake intubation.

Case presentation: We report a rare case of a patient with a large papillary carcinoma of the thyroid planned for surgical excision. The patient presented to our hospital with complaints of difficulty breathing while lying down in the supine position and oozing blood from the necrotic tissue. The breathing difficulties subsided in the lateral position.

Conclusion: We demonstrated how the left lateral position with an adjunct maneuver facilitates intubation in large thyroid malignancies.

Keywords

Awake intubation / Case report / Lateral position / Thyroid malignancy

Conflict of interest statement

The authors declare no conflict of interest.

Author contributions

Ahmad S, Kumar N, and Kumar A formulated the study idea and wrote the first draft of the manuscript. Palasevam S collected case data and revised the manuscript.

Funding

None.

Ethical approval of studies and informed consent

The study followed the principles of the Declaration of Helsinki as revised in 2013. The institution’s ethics committee states that the publication of case reports is exempt from ethical approval. Written informed consent was obtained from the patient for the use of her data and for the publication of the data that appear in this article.

Acknowledgments

None.

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