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Korean J Anesthesiol. 2018 Jun;71(3):232-236. doi: 10.4097/kja.d.18.27203. Epub 2018 Apr 24.

Successful airway management with combined use of McGrath® MAC video laryngoscope and fiberoptic bronchoscope in a severe obese patient with huge goiter -a case report.

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Department of Anesthesiology and Pain Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.


Huge goitor can lead to tracheal compression and hence difficulty in intubation. This is compounded by severe obesity. Failed tracheal intubation in difficult intubation is a serious event that may lead to increased patient morbidity and mortality. Current intubation rescue techniques and combination of different rescue techniques may increase the success rate of difficult intubation. In a 47-year-old female patient, with severe obesity and a huge goiter, our attempts at intubation using direct laryngoscope, video laryngoscope, and awake fiberoptic bronchoscope had failed. We succeeded by applying video laryngoscope to improve visualization of the airway and fiberoptic bronchoscope as a stylet for endotracheal tube.


Difficult intubation; Fiberoptic bronchoscope; Huge goiter; McGrath® MAC video laryngoscope

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