Abstract
C-MAC videolaryngoscope is a major advancement in difficult airway management as it not only facilitates intubation under vision but also diagnoses airway problems. We present a unique case of difficult airway for head and neck cancer surgery, where tube passage was impeded by a mucous overhanging structure between the base of epiglottis and the vocal cords. A nasotracheal tube was successfully negotiated under C-MAC guidance and the entire perioperative course was uneventful. DOI: http://dx.doi.org/10.4038/slja.v23i1.7303
Highlights
After assessing nasal patency and adequate nasal preparation, a 7mm flexomettalic cuffed tube was passed into the left nostril after standard induction of anaesthesia
Using C-MAC guidance and a magill forceps, the 6.5mm tube was successfully negotiated into the cords by tactfully avoiding the mucous overhanging anteriorly
Bilateral plastic reconstruction was done after the primary radical surgery and the patient was planned for elective ventilation to allow for graft uptake
Summary
Editor, - An elderly, hypertensive, female patient was posted for elective wide local excision with bilateral lymph node dissection and plastic reconstruction of malignant nonhealing ulcer on both angles of her mouth. She was edentulous with adequate mouth opening, normal neck movements and Mallampati grading 2. The onco-surgeons requested a nasotracheal tube to facilitate her reconstructive surgery and for possible postoperative retention of tube. After assessing nasal patency and adequate nasal preparation, a 7mm flexomettalic cuffed tube was passed into the left nostril after standard induction of anaesthesia.
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