A metal stylet is often used as an instrument to facilitate endotracheal intubation. It is very useful especially for difficult intubation cases. We experienced a case whereby the tip portion of a broken stylet was found in the ascending colon. The patient was a 71-year-old woman, who underwent cement filling and posterior fixation for a lumbar compression bone fracture. The tip of the stylet was thought to have fallen into the esophagus during endotracheal intubation. However, the anesthesiologist did not notice this accident at that time. Seven days after surgery, a periodical roentgenogram showed this foreign body. The next day, fortunately, it was discharged with a bowel movement without any complications. In order to prevent such iatrogenic accidents, periodical inspections of instruments are needed. Each anesthesiologist must be conscious of risk management and check the stylet before and after intubation. In addition, the metal stylet should not be bent frequently in the endotracheal tube.

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We reported two cases of awake craniotomy for removal of a brain tumor involving the premotor cortex using an endotracheal tube with a port for continuous topical anesthesia with lidocaine. To identify functional localization of the cortex around the tumor, motor function was monitored with intraoperative direct cortical stimulation while awake. We made a tracheal tube with an injection port of lidocaine at 1cm from the tip of a tube. We were able to maintain good airway management in an awake patient without bucking by continuous lidocaine infusion through the injection port.

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