[Vanishing glottis cyst following difficult intubation].

Area of Science:

• Anesthesiology
• Otolaryngology
• Gastroenterology

Background:

• A 68-year-old male patient presented for laparoscopic cholecystectomy under general anesthesia.
• Laryngoscopy revealed a thumb-sized tumor above the glottis, completely obscuring the vocal cords.

Observation:

• The tumor presented a risk of impaction into the glottis, potentially causing total airway obstruction during tracheal intubation.
• A fiberscope via a Fastrach laryngeal mask visualized the tumor as a soft cyst.
• A fiberoptic bronchoscope was advanced through a gap between the cyst and epiglottis into the trachea.

Findings:

• The fiberoptic bronchoscope facilitated railroading a tracheal tube, securing the airway.
• The patient could breathe spontaneously without the tracheal tube post-procedure.
• Post-extubation, the patient experienced no breathing or phonation difficulties.

Implications:

• This case highlights a successful airway management strategy for unexpected supraglottic tumors during elective surgery.
• The cyst may have spontaneously ruptured or been absorbed, as no post-operative abnormalities were noted.
• Early recognition and flexible endoscopic techniques are crucial for managing such challenging airway scenarios.