Featureless Trachea Mimicking the Esophagus During Awake Fiberoptic Intubation Secondary to Longstanding Thyroid Compression

Giant thyroid masses causing prolonged tracheal compression may lead to severe tracheomalacia, where progressive erosion of cartilaginous rings renders the trachea smooth, featureless, and difficult to distinguish from the esophagus during bronchoscopy. This poses a significant risk during awake fiberoptic intubation. Such airway distortion requires heightened vigilance, meticulous endoscopic assessment, and confirmation of tracheal entry to prevent misplacement. Early recognition and a systematic airway strategy are crucial for optimal patient safety and outcomes.