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Case report
Failed videolaryngoscopy in an infant with giant vallecular cyst managed successfully with a ‘three-person technique’ of fibre-optic intubation
  1. Anju Gupta1 and
  2. Nishkarsh Gupta2
  1. 1 Anesthesiology and Intensive Care, Vardhman Mahavir Medical College, Safdarjung Hospital, New Delhi, India
  2. 2 Onco-Anaesthesiology and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Nishkarsh Gupta, drnishkarsh{at}


Vallecular cysts are a rare entity but can complicate the airway management due to the physical impediment and distortion of the laryngeal inlet. It can lead to fatal life-threatening airway obstruction postinduction of anaesthesia. Infancy compounds the risks due to lack of cooperation and physiological reserves. The literature review suggested most anaesthesiologists avoided muscle relaxants and aspiration of the cyst was used as a rescue technique. The present case report illustrates the successful airway management of an infant with a huge vallecular cyst using fibre-optic intubation by a ‘three-person’ technique after paraglossal videolaryngoscopy failed to secure the airway.

  • anaesthesia
  • paediatrics
  • paediatric surgery

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  • Contributors AG: managed the case,collected and interpreted data, reviewed literature, written draft and approved final version. NG: interpreted data, reviewed literature, written draft and approved final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.