Fiberoptic tracheal intubation aided by jaw lifting in a patient with an epiglottic cyst

Epiglottic cyst is known to cause difficult intubation. We report a patient with an epiglottic cyst whose trachea was successfully intubated with the aid of fiberoptic bronchoscopy combined with the jaw lift maneuver. A 29-year-old patient was scheduled for lumbar disk hernia surgery. On the first occasion, surgery was cancelled since the patient was unexpectedly found to have an epiglottic cyst and tracheal intubation was not possible. Two weeks later, nasotracheal intubation guided by fiberoptic bronchoscopy under conscious sedation was planned. On the first attempt of bronchoscopy, the glottic view was obscured by the cyst displacing the epiglottis posteriorly. Next, we applied the jaw lift maneuver in conjunction with bronchoscopy. The maneuver improved the glottic view by clearing the epiglottis from the posterior pharyngeal wall and the patient's trachea was successfully intubated. Jaw lifting could be a useful adjunct to fiberoptic bronchoscopy for tracheal intubation in patients with epiglottic cysts.