[Difficult airway management in a man with large pharyngeal tumor]

A 58-year-old man (height 164 cm, weight 64 kg) complained of hoarseness one week prior to admission, and breathing difficulty from the previous day. From endoscopic observation, a pedunculated mass below the glottus was oscillating when breathing. Laryngomicrosurgery and tracheotomy were scheduled to remove the pharyngeal tumor. After oxygenation, continuous propofol infusion was carried out. Because mask or LMA ventilation was not possible, a cricothyroid membrane incision kit was inserted and the airway was secured. Laryngomicrosurgery was then performed and after the tumor resections, LMA was inserted and tracheotomy was carried out. In retrospect, a better alternative method would have been to use the cricothyroid membrane incision kit under local anesthesia for airway management.