2025, Vol. 8, Issue 1, Part A

Background: Securing airway is crucial to anesthetic management. Neglect in patients with massive cervical masses is not without danger, especially when there is anatomical changes in the mass and/or compressive symptoms.

Case: A 47-year-old female, known case of schizophrenia, presented with progressive neck swelling causing increasing difficulty in breathing. Patient also gave history of difficulty in lying supine. The patient underwent a successful surgical excison of an anterior neck mass wherein awake fibreoptic intubation was used to secure airway. This report aims to highlight the importance of careful planning and execution of perioperative airway management for optimizing patient safety.

Conclusion: Prior imaging for preoperative assessment as to tracheal displacement and compression, anticipation of a difficult airway along with alternative strategies in managing the situation are the key considerations for perioperative management of airway involving large neck masses causing tracheal compression.