Abstract
Giant vocal cord polyps pose challenges in airway management, particularly in patients with severe obstructive sleep apnea-hypopnea syndrome. We present the case of a morbidly obese man in his 20s (body mass index: 50.8 kg/m(2)) with severe obstructive sleep apnea-hypopnea syndrome and a giant vocal cord polyp. He successfully underwent awake tracheal intubation using video laryngoscopy and high-flow nasal oxygen, which was administered at 30 L/min. Airway anesthesia was achieved with lidocaine, including bilateral superior laryngeal nerve blocks. A 6.5-mm endotracheal tube was placed within 30 s, maintaining the peripheral capillary oxygen saturation level at 100%. The patient remained cooperative and spontaneously breathing throughout the procedure. No complications were observed postoperatively, and the patient was discharged the following day. This case illustrates the effectiveness of awake tracheal intubation and provides valuable insights into managing complex airway cases.