Introduction: The term "goitre" describes an abnormal thyroid gland enlargement. Goiter
prevalence ranges from 80% in iodine-deficient regions and 1%–4% in areas of affluent countries
with abundant iodine. We anaesthesiologist face airway challenges while treating patients
with severe neck swellings because tracheal intubation failure can have serious consequences
for morbidity and mortality.
Case Report: In this case we present a 40-year-old male which is a case of colloid goitre
posted for total thyroidectomy. Pre anaesthetic evaluation done, shifted to OT, pre-medicated
with standard drugs. Difficult bag and mask ventilation were faced during pre-oxygenation.
Hence Awake VLS was done to visualize vocal cords. Patient was induced with standard drugs
and VLS with Bougie assistance airway was secured with ET tube 8mm ID. Intraoperative
vitals stable, Patient reversed after assessing all the extubation criteria. Patient extubated and
shifted to post-op ward. Patient got discharged under stable condition on POD 14.
Conclusion: In patients with goitres, difficult airways can be managed using a variety of
strategies. We can proceed with conventional airway management if all the airway examination
is within normal limits, and there is no tracheal compression or deviation. Awake intubation
with video laryngoscopy is an ill-defined notion that largely depends on individual preference.
In this case we have managed a case of neck swelling with awake VLS intubation.