Tongue depressor as an intubation aid in a patient with vallecular cyst: A case report

Abstract

Introduction: Vallecular cyst is a rare occurring often encountered incidentally, which may compromise the airway during induction of anesthesia. There is a high risk for cyst rupture and soiling of the airway during manipulation of the airway. Case Report: We report a case of a young 23-year-old female with a history of difficulty in breathing and swallowing for the past 1½ years. She underwent emergency tracheostomy and excision of some oral swelling 10years back. She was electively booked for excision of the cyst. Various techniques and instruments have been described in the past. We used a tongue depressor to gently push the cyst aside and successfully rail loaded a reinforced endotracheal tube over a gum elastic bougie. Conclusion: Intubation in a patient with oropharyngeal cyst poses a significant risk in view of complete airway obstruction or aspiration of the contents in case rupture of the cyst. Various techniques for intubation have been reported, either awake or under general anesthesia. We successfully used a tongue depressor to shift the cyst away as an aid for intubation. This technique has so far not been reported in the literature. Keywords: Vallecular cyst, induction, tongue depressor.