A Case Report: Anesthetic Management of a Patient with Unexpected Difficult Airway Due to an Asymptomatic Giant Epiglottic Cyst

Background Epiglottic cysts are non-cancerous lesions, and their causes are mainly related to blockage of mucus gland discharge channels and accumulation of secretions. Huge epiglottic cysts generally have no obvious symptoms at the beginning, but when they gradually grow, they can lead to poor breathing, a foreign body sensation in the pharynx, acute epiglottitis, etc. Patients with asymptomatic epiglottic cysts may face difficulties in airway management during anesthesia-related emergencies, may lead to poor ventilation or difficulty intubation during rapid induction of general anesthesia, and may require tracheotomy in extreme cases. Objective To explore strategies for identifying and managing unexpected difficult airway in patients with asymptomatic giant epiglottic cyst after induction of anesthesia. Case presentation A 60-year-old woman was diagnosed with gallbladder stones with cholecystitis upon admission and decided to undergo laparoscopic cholecystectomy. After induction of anesthesia, difficulty in ventilation with a mask occurred. A huge cyst was seen to obscure the glottis during video laryngoscope intubation, and the first tracheal intubation failed. Conclusion A comprehensive anesthesia assessment is crucial for any surgery, especially for patients at risk of difficult airways. Asymptomatic giant epiglottic cysts are a potential airway crisis factor. Timely use of video laryngoscope can facilitate airway assessment, and appropriate ventilation tools can provide assistance in the event of failure of intubation.