Abstract
A 75-yr-old male was scheduled for ileocecal resection for polyposis. Preanesthetic airway examination showed no abnomalities. Direct laryngoscopy after a rapid-sequence induction of anesthesia revealed enlarged lingual tonsils. The arytenoids and epiglottis could not be seen, even with a fiberscope. Maintaining ventilation by mask was difficult, so an LMA was used. An attempt at fiberoptic endotracheal intubation through the LMA failed because hypertrophic tonsils interfered with fiberoptic exposure. Fiberoptic retro-grade endotracheal intubation was successful even when ventilating with an LMA.
