International Medical Case Reports Journal (Jan 2022)
Awake Intubation for a Case of Giant Parapharyngeal Space Tumor Using McGrath MAC® Video Laryngoscopeq
Abstract
Ririko Nagabuchi,1 Hikari Minami,1 Makoto Sakikawa,2 Yoshiko Onodera,1 Megumi Kanao-Kanda,1 Hirotsugu Kanda1 1Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Japan; 2Department of Dentistry and Oral Surgery, Rinseikai Yoshida Hospital, Nayoro, JapanCorrespondence: Hirotsugu KandaDepartment of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan, Tel +81-166-68-2583, Fax +81-166-68-2589, Email [email protected]: Intubation and ventilation cannot be performed in cases of parapharyngeal space tumors as the enlargement of the upper airway leads to the obstruction and hindrance of the intubation procedure. However, there is limited literature on anesthetic management, including the airway, in this disease. Herein, we report a successful case of awake intubation in a patient with parapharyngeal space tumor.Case Presentation: A 64-year-old man with a history of giant parapharyngeal space tumor was scheduled for bilateral endoscopic sinus surgery and nasal septoplasty. We performed awake intubation using the McGrath® video laryngoscope, which resulted in excellent laryngeal deployment and a smooth procedure.Conclusion: We report the anesthetic management of a giant parapharyngeal space tumor with the potential for difficult airway management to maintain spontaneous breathing. Awake intubation was useful in maintaining ventilation and intubation in this case. The preparation of a cricothyroid puncture is needed in cases of intubation failure.Keywords: parapharyngeal space tumor, awake intubation, video laryngoscope
