rca Revista Colombiana de Anestesiología Rev. colomb. anestesiol. 0120-3347 SCARE-Sociedad Colombiana de Anestesiología y Reanimación 10.1097/CJ9.0000000000000089 00009 Images The usefulness of the videolaryngoscope for the diagnosis of an unknown epiglottic tumor Utilidad del videolaringoscopio en el diagnóstico de un tumor de epiglotis no conocido Benítez-Jiménez Mercedes a Rodríguez-Navarro María Ángeles b * González-Pérez Petra b Díaz-Alejo Clara a Alcaraz-Martínez Ana Belén a Sánchez-Ródenas Lorenzo b Residente en anestesiología. Departamento de Anestesia y Dolor, Hospital general universitario J.M. Morales Meseguer. Murcia, España Departamento de Anestesia y Dolor Hospital general universitario J.M. Morales Meseguer Murcia España Residente en anestesiología. Departamento de Anestesia y Dolor, Hospital general universitario J.M. Morales Meseguer. Murcia, España Departamento de Anestesia y Dolor Hospital general universitario J.M. Morales Meseguer Murcia España Residente en anestesiología. Departamento de Anestesia y Dolor, Hospital general universitario J.M. Morales Meseguer. Murcia, España Departamento de Anestesia y Dolor Hospital general universitario J.M. Morales Meseguer Murcia España Anesthesia and Pain Department, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain. Anesthesia and Pain Department Hospital General Universitario J.M. Morales Meseguer Murcia Spain Marodrigueznavarro@yahoo.es Anesthesia and Pain Department, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain. Anesthesia and Pain Department Hospital General Universitario J.M. Morales Meseguer Murcia Spain Anesthesia and Pain Department, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain. Anesthesia and Pain Department Hospital General Universitario J.M. Morales Meseguer Murcia Spain Correspondence: Anesthesia and Pain Department, Hospital General Universitario J.M. Morales Meseguer, Calle Marqués de los Vélez, Murcia 30009, Spain. E-mail: Marodrigueznavarro@yahoo.es Jan-Mar 2019 47 1 69 70 This is an open-access article distributed under the terms of the Creative Commons Attribution License Keywords: Airway Management Laryngoscopy Epiglottis Laryngeal Neoplasms Intubation. Palabras clave: Manejo de la vía aérea Laringoscopía Epiglotis Neoplasias Laríngeas Intubación.

The contribution of video-laryngoscopy to improving the process of orotracheal intubation has been shown if various publications emphasizing an improved and better quality vision of the mouth and the larynx; it is extremely valuable for teaching purposes and is part of the algorithm for the intubation of a predicted difficult airway.1,2

This article discusses the case of a 54-year-old patient admitted to the emergency OR for surgery of an ascending colon neoplasm and secondary intestinal obstruction. The patient has a history of smoking 10 packs/year, criteria consistent with chronic bronchial disease, and hepatitis C.

In the light of the risk of bronchoaspiration, induction, and rapid sequence intubation were conducted uneventfully. During the laryngoscopy with a Macintosh, an epiglottic mass was identified. Following the intubation and the tracheal pneumo-tamponade, we conducted a second laryngoscopy using a video laryngoscope Glidescope Titanium (Verathon Medical Bothell, WA, USA), which clearly revealed an epiglottic tumor.

After obtaining the consent of a family member, the planned hemicolectomy was conducted, in addition to a resection through laryngeal microsurgery and a biopsy of the epiglottic tumor identified (0.75 cm) (Fig. 1A and B).

(A) Epiglottic mass seen through the video-lanryngoscope. (B) Epiglottic mass following the surgical resection. Source: Authors.

Several papers argue that the total time elapsed during intubation and isolation of the airway is longer with the use of the video-laryngoscope versus the routine laryngoscopy, when the operator is still in the learning curve2; this is why the laryngoscope was used.

The use of video-laryngoscopes-Glidescope, King Vision-initially designed to facilitate orotracheal intubation, is very frequent in the algorithm for managing a difficult airway,3 in addition to a very exciting application in oropharyngeal surgery.4 Furthermore, we find that the device allows for an easy and minimally invasive exploration as compared against laryngoscopy using a rigid laryngoscope, as illustrated in our case in which the problem was solved in the same surgical-anesthetic procedure.

Ethical disclosures

Protection of persons and animals: The authors claim that no experiments in humans or animals were conducted for this research.

Confidentiality of the information: The authors declare that they followed the protocols of their workplace with regard to disclosure of patient data.

Right to privacy and informed consent: The authors declare that this article does not disclose any patient information.

 References 1. Griesdale DE, Liu D, McKinney J, et al. Glidescope(r) video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anaesth 2012;59:41-52. Griesdale DE Liu D McKinney J Glidescope(r) video-laryngoscopy versus direct laryngoscopy for endotracheal intubation a systematic review and meta-analysis Can J Anaesth 2012 59 41 52 2. Lewis SR, Butler AR, Parker J, et al. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev 2016;11:CD011136. Lewis SR Butler AR Parker J Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation Cochrane Database Syst Rev 2016 11 CD011136 CD011136 3. España Fuente L, De la Rica Fernández P, González González JL. Use of King Vision videolaryngoscope in an unanticipated difficult airway in an adult patient with giant vallecular cyst, a case report. Rev Esp Reanim 2017;64:61-67. España Fuente L De la Rica Fernández P.González González JL Use of King Vision videolaryngoscope in an unanticipated difficult airway in an adult patient with giant vallecular cyst, a case report Rev Esp Reanim 2017 64 61 67 4. Bruno E, Dauri M, Mauramati S, et al. Utility of glidescope videolaryngoscopy in surgical procedures involving the larynx. Acta Otorhinolaryngol Ital 2015;35:45-48. Bruno E Dauri M Mauramati S Utility of glidescope videolaryngoscopy in surgical procedures involving the larynx Acta Otorhinolaryngol Ital 2015 35 45 48

Benítez-Jiménez M, Rodríguez-Navarro MA, González-Pérez P, Díaz-Alejo C, Alcaraz-Martínez AB, Sánchez-Ródenas L. The usefulness of the videolaryngoscope for the diagnosis of an unknown epiglottic tumor. Colombian Journal of Anesthesiology. 2019;47:69-70.

Author's own resources.

Authors declare no conflicts of interest implied in the writing of this manuscript.