Difficult Endotracheal Intubation Due to an Epiglottic Mass: A Case Report

Epiglottic masses may present as cystic, infectious, neoplastic, or systemic disease manifestations. Their size and location can lead to airway obstruction, increasing the difficulty of general anesthesia induction. Perioperative management for such patients requires meticulous planning to prevent sudden airway challenges post-anesthesia. Multidisciplinary collaboration (anesthesiology and otolaryngology) and the use of visualization devices (e.g., video laryngoscopy) are critical for ensuring airway safety. We described the anesthesia management for a 69-year-old male with a glottic mass. Laryngoscopy and CT revealed a 2.7×2.0 cm cauliflower-like mass on the lingual surface of the epiglottis (squamous high-grade intraepithelial neoplasia/carcinoma in situ). After comprehensive evaluation of the airway and perioperative drug interactions, appropriate sedatives, analgesics, and muscle relaxants were selected. The patient successfully completed the surgery and was discharged. The selection of the anesthesia intubation approach for epiglottic masses should be predicated on the size and location of the masses, along with the patient's specific circumstances. This case underscores the significance that conducting a thorough preoperative assessment of the patient prior to surgery and implementing multidisciplinary cooperation in light of the patient's condition can substantially mitigate anesthesia - related risks. Video laryngoscopy-assisted endotracheal intubation is the preferred method for protecting lingual epiglottic masses, minimizing tumor injury risks. However, its successful and safe implementation requires collaboration between experienced anesthesiology and otolaryngology teams.