Facing the Unexpected: A Case Report of Difficult Airway Situation

Abstract

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  Background: A difficult airway presents challenges in securing a clear and safe airway, often arising during intubation or ventilation due to anatomical or physiological factors. Effective recognition and management are crucial, involving tools such as video laryngoscopy and surgical interventions, as failure can lead to severe complications.

  
  

  Case Description: We report a 3-month-old male with congenital right fibular hemimelia and talipes calcaneovalgus, admitted to the pediatric ICU for upper airway obstruction. He exhibited paroxysmal cyanosis and stridor during crying and breastfeeding. On admission, he was cyanotic, in respiratory distress, and experienced a seizure. After stabilization with high-flow oxygen, he developed severe respiratory distress and bradycardia on day three, necessitating intubation. Video laryngoscopy revealed a large cystic mass obstructing the airway, confirmed by MRI as a loculated cystic lesion near the glottis and trachea.

  
  

  Conclusions: This case underscores the critical role of video laryngoscopy in managing difficult airways in pediatric patients. The enhanced visualization and accessibility provided by this technique improve intubation success and minimize complications, highlighting the need for its integration into clinical practice for similar cases.

  
  
  

  Keywords: Difficult intubation, Upper airway obstruction, Stridor, Cystic mass, Video laryngoscopy.