Awake Rigid Bronchoscopy With Ultrasound-Guided Superior Laryngeal Nerve Blocks in Severe Airway Obstruction: A Case Report

Rigid bronchoscopy is typically performed under general anesthesia, which can be unsafe in certain patients. The alternative is awake rigid bronchoscopy, which is rarely performed. This case concerns a patient with anaplastic thyroid cancer who presented with airway obstruction and respiratory distress. The patient had an obstructed trachea due to tumor invasion and compression. After performing ultrasound-guided superior laryngeal nerve blocks and airway topicalization to block the glossopharyngeal nerve, the obstruction was bypassed via an awake rigid bronchoscopy-guided tracheostomy. The awake rigid bronchoscopy procedure is feasible, and should be considered as an option in managing difficult airways.