A Large Cyst of the Mesopharynx Leading to Difficult Endotracheal Intubation

The case of a large cyst of the mesopharynx leading to difficult endotracheal intubation was reported. The patient was a 52-year-old man whose chief complaint was of a sore throat. This was diagnosed as caused by a large cyst of the mesopharynx in a nasopharyngeal fiberscopic study and with concurrent CT images. Under general anesthesia, the cyst was removed using a direct laryngoscope. At first, endoscopic intubation was impossible due to the size of the cyst. Therefore, just before intubation, the cyst was percutaneously punctured with an ultrasonography-guided fine needle, and the contents were aspirated. Thereafter, endoscopic intubation could be performed easily. We suggest that it is useful to puncture a cyst with an ultrasonography-guided fine needle in the case of a large benign cyst which may require tracheostomy for its removal.