A High, Large Epiglottis Disturbs Proper Positioning of the Laryngeal Mask and Cuffed Oropharyngeal Airway

Airway problems related to laryngeal mask airway use associated with an undiagnosed epiglottic cyst

This report describes airway management difficulties in a patient with an asymptomatic and undiagnosed epiglottic cyst. Mask ventilation after induction of general anesthesia was uneventful. Insertion of an LMA resulted in inadequate ventilation. Fiberoptic intubation through an intubating LMA was impossible because the LMA pushed the cyst into the laryngeal inlet. Fibreoptic intubation, assisted by the use of a direct laryngoscope without the LMA was uneventful. Preoperative craniocervical scans performed for assessment of other conditions may reveal asymptomatic pathology in the airway.