Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report

Introduction: Difficult airway management is a critical challenge in anesthesia, often necessitating advanced techniques to ensure patient safety. A patient presented with a malignant lesion on the epiglottis, significantly altering the airway anatomy. Flexible rhinolaryngoscopy revealed a laryngeal...

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Main Authors: Richard L. Witkam, Jörgen Bruhn, Nico Hoogerwerf, Rebecca M. Koch, Lucas T. van Eijk
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Anesthesia Research
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Online Access:https://www.mdpi.com/2813-5806/2/1/5
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author Richard L. Witkam
Jörgen Bruhn
Nico Hoogerwerf
Rebecca M. Koch
Lucas T. van Eijk
author_facet Richard L. Witkam
Jörgen Bruhn
Nico Hoogerwerf
Rebecca M. Koch
Lucas T. van Eijk
author_sort Richard L. Witkam
collection DOAJ
description Introduction: Difficult airway management is a critical challenge in anesthesia, often necessitating advanced techniques to ensure patient safety. A patient presented with a malignant lesion on the epiglottis, significantly altering the airway anatomy. Flexible rhinolaryngoscopy revealed a laryngeal carcinoma affecting the entire epiglottis, causing thickening and displacement, which suggested the potential for difficult intubation. Methods: Given the expected feasibility of bag-mask ventilation and front-of-neck access, an asleep intubation technique was selected. The combined use of a McGrath video laryngoscope and C-MAC video stylet allowed for fast and easy atraumatic intubation on the first attempt. The anesthetic and surgical course was uneventful. Discussion: This case report highlights the successful use of a combined approach involving a video laryngoscope and video stylet for intubation in a patient with known difficulties in airway management, providing insights into the benefits of enhanced visualization and maneuverability. The rigid design and steerable tip of the C-MAC video stylet provide advantages over traditional flexible optics, offering better maneuverability and reducing the need for a second operator. Although this technique was successful in this case, its use in patients with complex airway pathologies warrants careful preoperative assessment and collaboration with an experienced airway management team.
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spelling doaj-art-b4d07e899fea40448a3f6ef97bb5ca3b2025-08-20T02:30:45ZengMDPI AGAnesthesia Research2813-58062025-02-0121510.3390/anesthres2010005Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case ReportRichard L. Witkam0Jörgen Bruhn1Nico Hoogerwerf2Rebecca M. Koch3Lucas T. van Eijk4Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, 6500 HB Nijmegen, The NetherlandsDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, 6500 HB Nijmegen, The NetherlandsDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, 6500 HB Nijmegen, The NetherlandsDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, 6500 HB Nijmegen, The NetherlandsDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101, 6500 HB Nijmegen, The NetherlandsIntroduction: Difficult airway management is a critical challenge in anesthesia, often necessitating advanced techniques to ensure patient safety. A patient presented with a malignant lesion on the epiglottis, significantly altering the airway anatomy. Flexible rhinolaryngoscopy revealed a laryngeal carcinoma affecting the entire epiglottis, causing thickening and displacement, which suggested the potential for difficult intubation. Methods: Given the expected feasibility of bag-mask ventilation and front-of-neck access, an asleep intubation technique was selected. The combined use of a McGrath video laryngoscope and C-MAC video stylet allowed for fast and easy atraumatic intubation on the first attempt. The anesthetic and surgical course was uneventful. Discussion: This case report highlights the successful use of a combined approach involving a video laryngoscope and video stylet for intubation in a patient with known difficulties in airway management, providing insights into the benefits of enhanced visualization and maneuverability. The rigid design and steerable tip of the C-MAC video stylet provide advantages over traditional flexible optics, offering better maneuverability and reducing the need for a second operator. Although this technique was successful in this case, its use in patients with complex airway pathologies warrants careful preoperative assessment and collaboration with an experienced airway management team.https://www.mdpi.com/2813-5806/2/1/5anticipated difficult airwaylaryngeal tumorvideo laryngoscopevideo styletone operator airway management technique
spellingShingle Richard L. Witkam
Jörgen Bruhn
Nico Hoogerwerf
Rebecca M. Koch
Lucas T. van Eijk
Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
Anesthesia Research
anticipated difficult airway
laryngeal tumor
video laryngoscope
video stylet
one operator airway management technique
title Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
title_full Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
title_fullStr Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
title_full_unstemmed Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
title_short Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
title_sort combining a mcgrath video laryngoscope and c mac video stylet for the endotracheal intubation of a patient with a laryngeal carcinoma arising from the anterior side of the epiglottis a case report
topic anticipated difficult airway
laryngeal tumor
video laryngoscope
video stylet
one operator airway management technique
url https://www.mdpi.com/2813-5806/2/1/5
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