Awake Fibreoptic Intubation In Sitting Position For Obstructive Hypopharyngeal Mass

Abstract

Obstructive hypopharyngeal masses represent a formidable challenge in airway management, particularly due to anatomical proximity to critical respiratory structures. These patients frequently present with progressive symptoms like dysphagia, muffled voice, inspiratory stridor positional dyspnoea—all of which portend a dynamic and potentially unstable airway, especially during sedation or induction. In such scenarios, conventional airway techniques may be impractical or dangerous. Awake fibreoptic intubation offers superior strategy by allowing maintenance of spontaneous ventilation and airway patency under direct visualization. We present the case of a young adult with a significant hypopharyngeal mass who underwent successful awake fibreoptic intubation in the sitting position, followed by surgical excision. The choice of position played a pivotal role in improving airway access and optimizing patient safety. This case highlights the meticulous preoperative planning, careful sedation, multidisciplinary coordination, readiness for emergency airway interventions. Awake fibreoptic intubation in sitting position can serve as a vital tool in the anaesthesiologist’s armamentarium, especially in managing anticipated difficult airways.