Case Report Experience of awake Fiberoptic Nasotracheal Intubation in an elderly Patient with Tonsil Cancer

Awake intubation with fiberoptic bronchoscopy (FOB) is a popular technique in patients with difficult intubation criteria. Preservation of spontaneous respiration by nasotracheal intubation with FOB accompanied by sedation was performed in a case assessed as difficult intubation due to a high Mallampati score at preoperative evaluation and the presence of a mass extending to the oral cavity. Following surgery, extubation criteria were achieved, and the patient was extubated without complications. This report describes a patient diagnosed with tonsil cancer and assessed as difficult intubation due to the location of the mass and in whom endotracheal tube placement with direct laryngoscopy was not possible, and eventually undergoing awake fiberoptic intubation by the nasal route.