Morbidly Obese Patient with Huge Thyroid ? An Airway Challenge

Morbid obesity with huge Goiter is a known risk factor for difficult airway. We report a case of 35 years old female having carcinoma thyroid with morbid obesity posted for total thyroidectomy. Her body weight was 138 kilogram with BMI of 50 kg/m2. On preoperative assessment she was short necked with mallampati grading of IV. Various techniques to handle airway in such situation have been recommended like fibreoptic bronchoscope guided intubation, LMA, PLMA, intubating LMA, tracheostomy etc. Due to morbid obesity, short neck and huge swelling in neck we planned LMA insertion in awake state. We tried to insert PLMA size-3 under local anaesthesia, which was successful in second attemp