Combined Use of the GlideScope and Flexible Fiberoptic Bronchoscope After Several Failed Intubation Attempts for a Retrosternal Thyroid Mass: A Case Report

Abstract

The combined technique of a GlideScope and flexible fiberoptic bronchoscope (FOB) was used for intubating a 73-year-old female patient who was known as having failed intubation trials with DL, GlideScope and FOB, each was used alone. The patient was electively scheduled for total thyroidectomy for a huge retrosternal thyroid mass. A computed tomography (CT) scan showed a large necrotic mass (measuring 8*13cm) with heterogeneous enhancement involving the thyroid gland and extending retrosternally to anterior mediastinum causing marked tracheal compression and deviation to the left side. While the patient was awake, a combined technique of Glidescope to improve visualization of the airway and FOB as a stylet for endotracheal tube was used successfully for intubation. The operation went smoothly, and the patient was shifted intubated to the intensive care unit (ICU). On the next day, the patient was fully awake and extubated.