Awake Fibreoptic Intubation in the Sitting Position in a Patient with a Huge Goitre

License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A 46-year-old woman was anesthetized for total thyroidectomy. The thyroid was massive, deviating the trachea to the right and causing attenuation of the trachea radiologically. She had symptoms of respiratory obstruction in the supine position. Awake FOB-guided intubation was done in sitting position after airway topicalisation, and the airway was intubated with difficulty with 7.0mm cuffed orotracheal tube. We describe this case in detail and discuss the significance of careful approach to planning and preparation in the management of such a case. 1. Case Report A 46-year-old female patient weighing 52 kg presented with a very large multinodular goitre for total thyroidectomy. She had no other systemic disease. The thyroid swelling was 30× 30 × 20 cm in size with a lobulated surface extending from the lower jaw to below the sternal notch (see Figures 1 and 2). There were no distended veins on the chest or retrosternal extension, but the patient gave a history of difficulty i