Sedation and fiberoptic intubation of a neonate with a cystic hygroma

The flexible bronchoscope (FB) has been used to secure the difficult airway in pediatric patients (1). Difficult intubations in patients with cystic hygromas have been performed in awake patients or after the induction of general anesthesia (2). A recent case report acknowledges the challenges of performing intubations in pediatric patients under sedation because of their inability to fully cooperate (3). The following case demonstrates the two step–two fiberoptic bronchoscopic tracheal intubation performed using sedation and topical anesthesia in a neonate with a difficult airway.