Combination of visual laryngoscope and bronchial occluder in a patient with subglottic stenosis undergoing lung cancer resection: A case report

Purpose Subglottic stenosis (SGS) poses a unique airway management challenge for surgery patients requiring anesthesia. We present a case of SGS who successfully underwent lung cancer resection with the combination of a visual laryngeal mask and occluder for general anesthesia. We discuss the diagnosis and airway management for this rare and life-threatening condition. Case presentation A 67-year-old female patient was admitted to the hospital due to pulmonary nodules for more than one month. The patient had a history of thoracoscopic resection of posterior mediastinal tumor under general anesthesia. The computed tomography (CT) revealed multiple solid nodules in the medial segment of the right middle lobe, suggesting peripheral lung cancer. The patient was initially arranged for lung cancer resection under general anesthesia with bronchial intubation. After three failed attempts for bronchial intubation, we found a moderate stenosis of the airway 1 cm below the glottis, confirming SGS. We then used a bronchial occluder combined with a visual laryngeal mask for general anesthesia and successfully performed the lung cancer resection. After surgery, the patient recovered well and was subsequently discharged from the hospital. Conclusion Clinicians should consider the possibility of SGS for patients with a history of intubation. The combined use of a bronchial occluder and visual laryngeal mask presents a novel, effective strategy for airway management in this patient. More studies are needed to validate the clinical safety and utility of this method further in the future.