# Unveiling the Success of Awake Insertion of Supraglottic Airway Device for Ventilation in the Bronchoscopic Management of Tracheal Stenosis

## TL;DR

This paper describes a successful case of managing tracheal stenosis using awake insertion of a supraglottic airway device during bronchoscopy.

## Contribution

The novel approach ensures safe ventilation during bronchoscopy in patients with airway compromise.

## Key findings

- Awake insertion of a supraglottic airway device allowed safe gas exchange during bronchoscopy.
- The intervention effectively managed stenosis and prevented airway collapse during sedation.
- Balloon dilatation, laser ablation, and mitomycin C application were successfully performed.

## Abstract

Tracheal and subglottic stenoses are inflammatory conditions that can arise from a variety of potential etiologies, most commonly as a result of iatrogenic airway injury due to endotracheal intubation. Significant stenosis requires management by endoscopy or surgical resection. We describe a case of recurrent subglottic cuff stenosis with an episode of sudden desaturation in a 25-year-old female. The management involved balloon dilatation, laser ablation, and topical mitomycin C application through a flexible fiberoptic bronchoscope. Ensuring safe gas exchange during bronchoscopy was a priority, and this was achieved by maintaining ventilation with a supraglottic airway device, which was inserted in an awake patient after adequate tropicalization of the oral cavity. The intervention successfully helped in the management of stenosis and also addressed the complication of sudden complete airway collapse due to sedation.