A novel method utilizing nasal positive pressure and video laryngoscopy assisted flexible bronchoscopic intubation: A case report

Treatment of locally advanced squamous cell carcinoma (SCC) of the head and neck often leads to anatomical distortions from the pathology itself or its treatment. Induction of anesthesia for surgical interventions poses a substantial risk of desaturation as these patients often have difficult airways. We present a 44-year-old female with stage IV SCC undergoing general endotracheal intubation using 3 concurrent modalities: video laryngoscopy, flexible bronchoscopy, and continuous high-flow nasal positive pressure oxygenation. The high-flow nasal oxygenation was used during intubation and extubation, permitting an increased margin of safety during manipulation of an anticipated difficult airway.