I read this forum every once in awhile and the posts I seem to enjoy most are case reports. I finally have one of my own to post: 71 year old 62" 52kg female presents for modified radical neck dissection, total laryngectomy and right hemithyroidectomy. The pt was dx with squamous cell CA of the right pyriform sinus (without esophageal or vocal cord extension per CT scan report) 3 weeks ago after DL and bx under GETA at our hospital. The pt has no other PMHx and is on no medications. She does have a 50 pack yr smoking hx but quit 1.5 years ago. The anesthesia record from the DL and bx 3 weeks ago indicates that intubation was successful after one attempt with a 6.0 ETT using a MAC 3 blade and grade 2 view. There are no other comments about the intubation other than the material above that is listed in the "fill in the blanks" airway section of the anesthesia record. Intubation was facilitated with Propofol and SUX. My attending and I spoke with the attending ENT regarding airway management prior to the case and he said the mass was small and non-obstructing 3 weeks ago with very minor medialization of the right vocal cord. The pt had no hx of stridor or hoarseness on interview and exam the morning of sx. How would you manage this airway? Please, no oral boards/text book answers (unless that's what you would do ) - we all know that the "proper" answer isn't always the right answer (or at least what we think is right )! After there are a few replies, I'll let you know what we did and what the outcome was.