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Combined use of a videolaryngoscope and a flexible bronchoscope for awake tracheal intubation when front‐of‐neck airway is not an option *
Author(s) -
Khan M. F.,
Shamim F.,
Slote M. U.,
Salim B.,
Abbas S. A.
Publication year - 2021
Publication title -
anaesthesia reports
Language(s) - English
Resource type - Journals
ISSN - 2637-3726
DOI - 10.1002/anr3.12091
Subject(s) - medicine , airway , stridor , intubation , surgery , anesthesia , bronchoscopy , tracheal intubation , respiratory distress , airway obstruction , airway management
Summary We report a case of successful tracheal intubation with the combined use of a videolaryngoscope and flexible bronchoscope in a patient with difficult airway when both techniques had individually failed. A 35‐year‐old man presented with airway obstruction due to massive neck swelling causing hypoxia, stridor and respiratory distress. He had a history of oral cancer which had been resected with bilateral neck dissection and free flap reconstruction 2 months previously. Due to extensive anterior neck swelling, we judged that front‐of‐neck airway would not be a suitable approach. After unsuccessful attempts at awake tracheal intubation with videolaryngoscopy and flexible bronchoscopy separately, we combined both techniques with a successful outcome. By using a combined technique to address the specific problems presented by this case, a life‐threatening emergency was resolved. This case highlights why it is useful for anaesthetists to be familiar with multiple techniques to awake tracheal intubation, both individually and in combination.