Awake Video Laryngoscope Guided Intubation (VLI) in a Case of Advanced Nasopharyngeal Carcinoma

Background: Awake video laryngoscope guided intubation is a reliable approach for securing the airway in patients with predicted or unexpectedly difficult airway conditions. Awake video laryngoscope-guided intubation which was developed in the early 2000s can be applied successfully in a variety of clinical settings with better patient preparation and implementation of the proper approach.

Case Presentation: On December 10, 2022, a 62-year-old male with advanced Nasopharyngeal Carcinoma with concomitant comorbidities resulting from earlier chemotherapy and radiotherapy underwent elective surgical tracheostomy. A fiber optic indirect laryngoscopy uncovered a narrow laryngeal inlet. A successful surgical tracheostomy was performed after a successful Awake video laryngoscope guided intubation using the C-Mack with a topical and injectable anesthetic. After awakening from anesthesia, the patient was moved to the ICU for routine observation. The patient recovered quickly and was discharged within a few days.

Conclusion: This case describes the successful management of an advanced Nasopharyngeal Carcinoma patient undergoing elective tracheostomy. The patient underwent Awake video laryngoscope guided intubation with the C-Mack, topical and injectable anesthetic, which allowed for a successful surgical tracheostomy despite the concomitant comorbidities from past treatment.