Awake C-MAC® video laryngoscopy for cystic hygroma in neonatal intensive care:A land less travelled

Airway management in neonates with cystic hygroma is challenging. Preservation of spontaneous ventilation and inhalational induction with sevoflurane in 100% O₂ may be the best option, but not feasible during an emergency where the extent of lesion and compression of airway structures were not known, particularly in a remote location due to risk of apnoea by sedation or intravenous induction of anaesthesia with compromised respiration. We present a successful emergency airway management by awake intubation using a C-MAC® video laryngoscope in a 2-day old term neonate weighing 2.2 kg with 12 × 9 cm cystic hygroma extending up to the thoracic inlet.