Case Report
Successful Awake Nasal Intubation for Difficult Airway Management in a Postpartum Woman Who Presented with Left Mandibular Soft Tissue Sarcoma: A Case Report
Tesfaye Asefa*
,
Minda Abebe,
Yusuf Ahmed,
Ebrahim Ahmed
Issue:
Volume 7, Issue 2, June 2026
Pages:
23-28
Received:
3 June 2026
Accepted:
15 June 2026
Published:
17 July 2026
DOI:
10.11648/j.wjmcr.20260702.11
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Views:
Abstract: Background: Soft tissue sarcomas (STSs) are rare malignancies. This type of tumor can cause airway obstruction, anatomical distortion, voice changes, and limitations in opening the mouth, which may complicate intubation or ventilation. Difficult airway management in oral and maxillofacial surgery focuses on maintaining airway reflexes and spontaneous breathing. This case report describes a novel approach to awake nasal intubation in a postpartum woman with left mandibular soft tissue sarcoma. Unlike previous studies that relied on ultrasound or bronchoscopic guidance for awake intubation, this report describes successful blind awake intubation using a transtracheal block. Case presentation: This is a 20-year-old gravida I, para I woman who presented with swelling on the left side of her face for five months. She presented with these symptoms 3 weeks after spontaneous vaginal delivery. The swelling started on the buccal mucosa as a small lesion prior to delivery. After the airway was anesthetized with 5 ml of 2% lidocaine gargle and 5 ml of 2% lidocaine injected through the cricothyroid membrane, awake, blind nasal intubation was successfully conducted. Conclusion: Effective management of difficult airways requires a well-planned strategy, multidisciplinary team discussion, and preoperative assessment. This case report contributes to the literature by demonstrating successful awake blind nasal intubation facilitated by a transtracheal block using 5 ml of 2% lidocaine administered at the cricothyroid membrane. In situations with limited resources, awake blind nasal intubation with a transtracheal block can be a valuable and practical technique for managing difficult intubations. However, it requires a trained and experienced anesthetist.
Abstract: Background: Soft tissue sarcomas (STSs) are rare malignancies. This type of tumor can cause airway obstruction, anatomical distortion, voice changes, and limitations in opening the mouth, which may complicate intubation or ventilation. Difficult airway management in oral and maxillofacial surgery focuses on maintaining airway reflexes and spontaneo...
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