Videolaryngoscope-guided awake tracheal intubation in a patient with invasive medullary thyroid carcinoma causing subglottic airway obstruction

Head-and-neck tumours are associated with a difficult airway due to the involvement of airway structures and infiltration into surrounding tissues. In clinical practice, awake tracheal intubation (ATI) is mainly performed with a fibreoptic bronchoscope. Videolaryngoscope-guided ATI has been proven to be equally effective in terms of patient comfort, safety profile and success rate. It also takes lesser time as compared to fibreoptic bronchoscopy provided adequate airway topicalisation is done and sedation carefully titrated with a suitable sedative. Formulating a good plan with team members, psychological preparation of the patient and choosing the right technique facilitated successful ATI in our patient with an anticipated difficult airway.