{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:29:07Z","timestamp":1772166547075,"version":"3.50.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Perioper Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While awake, flexible bronchoscopic intubation has long been considered the gold standard for managing anticipated difficult airways, the videolaryngoscope has emerged as a viable alternative. In addition, the decision to perform awake intubation or to proceed with airway management after induction of general anesthesia should be grounded in a comprehensive assessment of risks and benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 41-year old female patient was scheduled for excision of bilateral, mobile, and pedunculated masses on both aryepiglottic folds, which covered almost the entire upper part of the glottis. We conducted a comprehensive evaluation of the patient\u2019s signs and symptoms, which included neither stridor nor dyspnea in any position, along with the otolaryngologist\u2019s opinion and the findings from the laryngeal fiberscopic examination. Given the potential challenges and risks associated with awake flexible bronchoscopic intubation for this patient, we decided to proceed with gentle tracheal intubation using a videolaryngoscope under general anesthesia. In case of failed mask ventilation and tracheal intubation, we had preplanned strategies, including awakening the patient or performing an emergent tracheostomy, along with preparations to support these strategies. Ensuring that mask ventilation was maintained with ease, the patient was sequentially administered intravenous propofol, remifentanil, and rocuronium. Under sufficient depth of anesthesia, intubation using a videolaryngoscope was successfully performed without any complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Videolaryngoscopic intubation after induction of general anesthesia can be a feasible alternative for managing difficult airways in patients with supraglottic masses. This approachshould be based on a comprehensive preoperative evaluation, adequate preparation, and preplanned strategies to address potential challenges, such as inadequate oxygenation and unsuccessful tracheal intubation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13741-024-00377-9","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T12:02:21Z","timestamp":1710936141000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Managing a difficult airway due to supraglottic masses: successful videolaryngoscopic intubation after induction of general anesthesia"],"prefix":"10.1186","volume":"13","author":[{"given":"Hye-won","family":"Jeong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun-Jin","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun-A","family":"Jang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joungmin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"issue":"4","key":"377_CR1","first-page":"385","volume":"22","author":"AA Abdellatif","year":"2014","unstructured":"Abdellatif AA, Ali MA. GlideScope videolaryngoscope versus flexible fiberoptic bronchoscope for awake intubation of morbidly obese patient with predicted difficult intubation. Middle East J Anaesthesiol. 2014;22(4):385\u201392.","journal-title":"Middle East J Anaesthesiol"},{"issue":"1","key":"377_CR2","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/ALN.0000000000004002","volume":"136","author":"JL Apfelbaum","year":"2022","unstructured":"Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Dutton RP, Fiadjoe JE, Greif R, Klock PA Jr, Mercier D, et al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway*. Anesthesiol. 2022;136(1):31\u201381.","journal-title":"Anesthesiol"},{"issue":"Suppl","key":"377_CR3","doi-asserted-by":"publisher","first-page":"S26","DOI":"10.4097\/kjae.2010.59.S.S26","volume":"59 Suppl","author":"GS Choi","year":"2010","unstructured":"Choi GS, Park SI, Lee EH, Yoon SH. Awake GlideScope\u00ae intubation in a patient with a huge and fixed supraglottic mass -a case report. Korean journal of anesthesiology. 2010;59 Suppl(Suppl):S26-29.","journal-title":"Korean journal of anesthesiology"},{"issue":"5","key":"377_CR4","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1213\/00000539-198705000-00019","volume":"66","author":"AM Gambee","year":"1987","unstructured":"Gambee AM, Hertzka RE, Fisher DM. Preoxygenation techniques: comparison of three minutes and four breaths. Anesth Analg. 1987;66(5):468\u201370.","journal-title":"Anesth Analg"},{"issue":"1","key":"377_CR5","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1097\/00000542-200407000-00059","volume":"101","author":"R Han","year":"2004","unstructured":"Han R, Tremper KK, Kheterpal S, O\u2019Reilly M. Grading scale for mask ventilation. Anesthesiology. 2004;101(1):267.","journal-title":"Anesthesiology"},{"issue":"8","key":"377_CR6","doi-asserted-by":"publisher","first-page":"e139","DOI":"10.11622\/smedj.2015067","volume":"56","author":"G Liew","year":"2015","unstructured":"Liew G, Leong XF, Wong T. Awake tracheal intubation in a patient with a supraglottic mass with the Bonfils fibrescope after failed attempts with a flexible fibrescope. Singapore Med J. 2015;56(8):e139-141.","journal-title":"Singapore Med J"},{"issue":"1","key":"377_CR7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/00004630-198801000-00013","volume":"9","author":"SM Larson","year":"1988","unstructured":"Larson SM, Parks DH. Managing the difficult airway in patients with burns of the head and neck. J Burn Care Rehabil. 1988;9(1):55\u20136.","journal-title":"J Burn Care Rehabil"},{"issue":"7","key":"377_CR8","doi-asserted-by":"publisher","first-page":"3416","DOI":"10.1177\/0300060519851355","volume":"47","author":"S Min Lee","year":"2019","unstructured":"Min Lee S, Lim H. McGrath\u00ae videolaryngoscopy in an awake patient with a huge dangling vocal papilloma: a case report. J Int Med Res. 2019;47(7):3416\u201320.","journal-title":"J Int Med Res"},{"issue":"7","key":"377_CR9","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1046\/j.1365-2044.1999.01036.x","volume":"54","author":"RA Mason","year":"1999","unstructured":"Mason RA, Fielder CP. The obstructed airway in head and neck surgery. Anaesth. 1999;54(7):625\u20138.","journal-title":"Anaesth"},{"key":"377_CR10","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jclinane.2016.01.004","volume":"32","author":"M Nassar","year":"2016","unstructured":"Nassar M, Zanaty OM, Ibrahim M. Bonfils fiberscope vs GlideScope for awake intubation in morbidly obese patients with expected difficult airways. J Clin Anesth. 2016;32:101\u20135.","journal-title":"J Clin Anesth"},{"issue":"6","key":"377_CR11","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1097\/ALN.0b013e318254d085","volume":"116","author":"CV Rosenstock","year":"2012","unstructured":"Rosenstock CV, Th\u00f8gersen B, Afshari A, Christensen AL, Eriksen C, G\u00e4tke MR. Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management: a randomized clinical trial. Anesthesiol. 2012;116(6):1210\u20136.","journal-title":"Anesthesiol"},{"issue":"10","key":"377_CR12","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1111\/j.1365-2044.1993.tb07429.x","volume":"48","author":"VS Sidhu","year":"1993","unstructured":"Sidhu VS, Whitehead EM, Ainsworth QP, Smith M, Calder I. A technique of awake fibreoptic intubation Experience in patients with cervical spine disease. Anaesthesia. 1993;48(10):910\u20133.","journal-title":"Anaesthesia"},{"issue":"4","key":"377_CR13","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1093\/bja\/aer503","volume":"108","author":"MK S\u00f8rensen","year":"2012","unstructured":"S\u00f8rensen MK, Bretlau C, G\u00e4tke MR, S\u00f8rensen AM, Rasmussen LS. Rapid sequence induction and intubation with rocuronium-sugammadex compared with succinylcholine: a randomized trial. Br J Anaesth. 2012;108(4):682\u20139.","journal-title":"Br J Anaesth"}],"container-title":["Perioperative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13741-024-00377-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13741-024-00377-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13741-024-00377-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T12:05:59Z","timestamp":1710936359000},"score":1,"resource":{"primary":{"URL":"https:\/\/perioperativemedicinejournal.biomedcentral.com\/articles\/10.1186\/s13741-024-00377-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,20]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["377"],"URL":"https:\/\/doi.org\/10.1186\/s13741-024-00377-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3337086\/v1","asserted-by":"object"}]},"ISSN":["2047-0525"],"issn-type":[{"value":"2047-0525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,20]]},"assertion":[{"value":"8 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case report was approved by the Institutional Review Board of the Chonnam National University Hospital (IRB no. 2023-112).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21"}}