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This is a case report of a 75-year-old man scheduled for apical resection and cystectomy of odontogenic cysts involving both maxillary central incisors who presented with a previously unknown laryngeal mass that was discovered prior to intubation. Following induction and easy mask ventilation, direct laryngoscopy revealed a large mass on the right side of the glottis that impeded passage of a standard oral endotracheal tube. Successful atraumatic intubation was performed with the combination of a video laryngoscope (King Vision, Ambu Inc, Ballerup, Denmark) and a gum elastic bougie (GEB). Although a GEB may not be used routinely for tracheal intubation, it facilitated smooth advancement of the endotracheal tube without damaging the laryngeal mass when used in combination with video laryngoscopy.

Keywords: Laryngeal papilloma; Tracheal intubation; Video laryngoscope; Gum elastic bougie; General anesthesia
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Copyright: © 2020 by the American Dental Society of Anesthesiology
Figure 1.
Figure 1.

The video laryngoscope showing the unexpected laryngeal mass.

Figure 2.
Figure 2.

The laryngeal mass preventing ETT advancement into the trachea.

Figure 3.
Figure 3.

The GEB in place to guide the ETT past the laryngeal mass. GEB: gum elastic bougie.

Contributor Notes

Address correspondence to Dr Tomoka Matsumura, Tokyo Medical and Dental University, Dental Hospital 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549 Japan; tomoanph@tmd.ac.jp
Received: Dec 03, 2019
Accepted: Apr 14, 2020