Microlaryngeal surgery, difficult airway and a missing throat pack: C Mac D-blade to the rescue

Skilful use of the C Mac D-blade videolaryngoscope, with preservation of spontaneous respiration, can avert preoperative tracheostomy and guide microlaryngeal surgery (MLS) tube insertion in patients with large growths obliterating glottic view. The long narrow stylet accompanying double-lumen tubes can be used for D-Blade guided MLS tube orotracheal intubation. A definite protocol for safe insertion and removal of throat packs has been described here. Throat packs may go missing despite following protocols. Our algorithm includes visual and documentary precautions and means of exploration of missing throat packs. D-blade is invaluable in scanning the oropharynx in event of a lost throat pack.