Successful fiberoptic orotracheal intubation by lifting large thyroid mass and tongue protrusion in left lateral position: a case report

Abstract

Awake fiberoptic bronchoscopy has long been considered the criterion standard for the management of difficult airways because of large thyroid malignancies. After an unsuccessful attempt to intubate with a fiberoptic bronchoscope in the supine position, the decision to switch to the left lateral position was made. We present this case to propose the utilization of the lateral position for awake intubation. We report a rare case of a patient with a large papillary carcinoma of the thyroid planned for surgical excision. The patient presented to our hospital with complaints of difficulty breathing while lying down in the supine position and oozing blood from the necrotic tissue. The breathing difficulties subsided in the lateral position. We demonstrated how the left lateral position with an adjunct maneuver facilitates intubation in large thyroid malignancies.