Airway Management Using Spoon Forceps for Stabilization of a Large Vocal Cord Mass During Endotracheal Intubation: A Case Report

Abstract Tracheal intubation in patients with large, mobile, or friable glottic lesions may be complicated by lesion contact, displacement, bleeding, dynamic airway obstruction, or difficulty advancing the endotracheal tube. Here, we present a case of airway management using 4-mm cupped-jaw spoon forceps under video laryngoscopy in a 70-year-old man with a large vocal cord mass that was subsequently confirmed as granulation tissue. To facilitate intubation while limiting manipulation of the lesion, a coordinated two-person technique was performed. The primary operator introduced spoon forceps to gently support, stabilize, and displace the mass away from the endotracheal tube trajectory. Simultaneously, the second operator advanced a 6.5-mm internal-diameter plain endotracheal tube into the trachea on the first attempt without visible contact between the endotracheal tube and the lesion. Intubation was completed without mucosal bleeding, airway trauma, or lesion fragmentation. Postoperative histopathological examination confirmed ulcerated granulation tissue. Temporary mechanical stabilization of a mobile or friable laryngeal lesion using spoon forceps via a two-person approach under video laryngoscopy may represent a useful adjunct for facilitating endotracheal intubation while limiting inadvertent lesion manipulation.