Asymptomatic giant epiglottic cyst causing an unexpectedly difficult airway: a case report

Abstract

Background: Giant epiglottic cysts can cause throat discomfort, a sensation of foreign body presence in the throat, and respiratory distress. Furthermore, individuals without symptoms might face difficulties with airway management during anesthesia-related emergencies. In extreme situations, a tracheostomy might be required.

Case presentation: A 61-year-old man, who was diagnosed with a left heel spur, decided to undergo an arthroscopic osteotomy. The process of ventilating with an anesthesia mask grew more difficult and eventually impossible following the insertion of the laryngeal mask. The giant epiglottic cyst was identified through video laryngoscopy, which also facilitated successful tracheal intubation.

Conclusion: For any surgery, it is essential to conduct a comprehensive anesthesia assessment, particularly for difficult airway risks. Using video laryngoscopy promptly can enhance intubation success, and suitable ventilation tools can help in failed intubation scenarios. While new technologies can facilitate airway assessment and management, mastering techniques like FONA techniques is still essential. However, calling for help in all cases remains paramount.

Keywords: Anesthesia assessment; Difficult airway; Epiglottic cyst; Tracheal intubation; Video laryngoscope.

Fig. 1

The intubation process

Fig. 2

A giant epiglottic cyst measuring 2 × 3 cm was identified during video laryngoscopy, occupying the entire epiglottic surface and completely obscuring the vocal folds prior to intubation. Additionally, the cyst impeded effective laryngeal mask ventilat

Fig. 3

The image demonstrates that the epiglottis has altered from its original morphology following the excision of the epiglottic cyst