Combination of visual supraglottic airway and bronchial occluder in a patient with subglottic stenosis undergoing lung cancer resection: a case report

Subglottic stenosis (SGS) poses a unique airway management challenge for surgery patients requiring general anesthesia. We report a case of successful lung cancer resection in a patient with SGS using a combination of a visual supraglottic airway device and bronchial occluder. We discuss the diagnosis and airway management for this rare and life-threatening condition. A 67-year-old female patient was admitted to the hospital due to pulmonary nodules for more than one month. She had a history of thoracoscopic resection of posterior mediastinal tumor under general anesthesia. The computed tomography (CT) revealed multiple solid nodules in the medial segment of the right middle lobe, suggesting peripheral lung cancer. The patient was initially scheduled for lung cancer resection under general anesthesia with bronchial intubation. Following three unsuccessful attempts at bronchial intubation, a moderate stenosis of the airway was identified 1 cm below the glottis, confirming the presence of subglottic stenosis (SGS). We then utilized a bronchial occluder in combination with a visual supraglottic airway device to administer general anesthesia, and successfully completed the lung cancer resection. Postoperatively, the patient demonstrated favorable recovery and was subsequently discharged from the hospital. The combined use of a bronchial occluder and a visual supraglottic airway device may represent an effective strategy for airway management that avoids exacerbating airway injury and achieves satisfactory lung collapse in this patient with SGS. Further studies are warranted to validate the safety and utility of this approach.