Airway Management With a GlideScope® Spectrum LoPro Blade in a Child With Giant Facial Rhabdomyosarcoma: A Case Report.
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Difficult airways can cause severe hypoxia when inducing general anesthesia unless they are well managed, especially for pediatric patients. Successful management of pediatric difficult airways requires meticulous assessments and preparations. The GlideScope® Spectrum LoPro is a thin, hyperangulated blade. Although its utility has been demonstrated in previous studies on Pierre Robin manikins or patients with severely restricted mouth openings, as yet there have been no case reports on its efficacy for children with difficult airways. We encountered a 14-year-old female patient with giant facial rhabdomyosarcoma who was scheduled for tumor debulking surgery under general anesthesia. Her mouth opening was limited to 2 child finger-widths, with Mallampati Classification IV, meaning an anticipated difficult airway. For this anticipated difficult airway, we prepared several airway devices and planned our possible approaches carefully. When industry-standard options became untenable, we switched to the GlideScope® LoPro blade, completing oral intubation under spontaneous breathing without any complications. This result demonstrated that the GlideScope® Spectrum LoPro blade is useful and effective for at least some forms of difficult airways, with confirmation that it is useful in cases involving giant facial tumors. Its hyperangulated blade offered improved vocal cord visualization. Overall, we have concluded that its use in specialized cases could increase intubation success rates for pediatric patients.