Navigating airway challenges in cystic hygroma: I-gel as a vital tool

Abstract

Cystic hygroma, sometimes also known as cavernous hemangioma, is a benign congenital tumour that develops during nine and sixteen weeks of pregnancy. It is caused by an obstruction in the lymphatic system and manifests as a cyst or soft sac filled with fluid. The airway of neonates and young infants with cystic hygroma can be very challenging for any anaesthetist, as airway obstruction, hypoventilation, hypoxemia, and sudden collapse are very common due to the extension of tumour in the neck, airway, and thorax. These patients can present as being asymptomatic to having stridor. We share one such case of a young child with cystic hygroma, successfully managed with I-Gel without any complication in a NORA (Non-Operating Room Anesthesia) setting suggesting that, SADs can be used electively as the primary device for airway management in the challenging airways after proper patient evaluation.