# Awake Videolaryngoscopy for Intubation in Patients With Laryngeal Cancer: A Case Series

## TL;DR

This case series explores using awake videolaryngoscopy for intubation in laryngeal cancer patients to avoid complications during surgery.

## Contribution

Reports a novel approach of awake intubation without sedatives in laryngeal cancer surgery to prevent intubation failure.

## Key findings

- Awake videolaryngoscopy was successfully used in four patients with supraglottic tumors.
- The method avoided complications from intubation failure and tumor-related airway obstruction.
- No sedatives were used, maintaining spontaneous breathing during the procedure.

## Abstract

Total laryngectomy is the gold standard surgical approach for laryngeal cancer and is generally conducted under general anesthesia. Orotracheal intubation remains a very delicate step in the general anesthesia process. In otolaryngology (ENT) surgery, it remains considered the preferred method of anesthesia for many surgical procedures. A significant challenge in oncological ENT surgery is the difficulty associated with orotracheal intubation, due to a number of reasons that can lead to failure of orotracheal intubation. To mitigate this risk, experts recommend proceeding with orotracheal intubation with the patient awake and breathing spontaneously. In this case series, we report four patients with supraglottic tumors of the larynx who underwent total laryngectomy surgery under general anesthesia, during which they underwent orotracheal intubation while awake and spontaneous breathing, under no sedative drugs of any kind, in order to avoid complications of orotracheal intubation failure and respiratory apnea due to bleeding tumor masses that engaged the supraglottic space.