Category Archives: Airway

3D Printed Battery Holder for McGrath Video Laryngoscopes.

Our department has a large number of McGrath video laryngoscopes. The battery packs were stored in the anesthesia tech room as follows:


This seemed like a poor way to store batteries that cost $75 each. I Designed and 3D printed a tray to hold the batteries; the goal being to provide better organization, improved accessibility, and assist the techs with inventory/ordering. Here is the 3D design:


And here is the final printed product:


Unanticipated Glottic Papilloma

We provided a general anesthetic to a 35 year old male for surgical reduction of a displaced clavicular fracture. The patient’s history was significant for obesity and daily tobacco smoking. During preoperative assessment the patient was noted to have a hoarse voice; however, we were reassured by the patient’s report that his voice had been this way for “a very long time.” A previous anesthetic record was avalible and notable for two hand mask ventilation with an oral airway and grade 2B intubation view with direct laryngoscopy. His BMI had increased from 27 to 39 since the previous record.

We performed a standard induction which was initially notable for very difficult mask ventilation. We performed planned video laryngoscopy with a McGrath MAC #4 resulting in the following view:


Due to difficult mask ventilation we proceeded with intubation without fully investigating the mass. The mass was mobile posteriorly and we were able to easily pass a 6.0 ETT into the trachea:


Since the patient’s injury required urgent repair, we proceeded with the surgery without delay. We called for an intraoperative ENT consult. The ENT surgeon used a gum bougie to delineate the mass and determined that it was attached anteriorly and such masses are unlikely to compromise an airway acutely. Since extubation was likely safe, the ENT surgeon did not perform a biopsy or excision, so the patient could be properly consented for the procedure at a later date. We extubated the patient fully awake without complication.

In the PACU we questioned the patient again with family present. The patient’s wife immediately reported that she noticed a worsening of the patient’s usual hoarseness over the past 3 months.

The patient returned to the OR 1 week later for definitive diagnosis and excision of the mass. We induced the patient and intubated with a Karl Storz C-MAC S MAC #4 and 5.0 microlaryngoscopy ETT:

The mass was resected by the ENT surgeon and was shown to be a papilloma by pathology.

Lego Minifig Anesthesiologist.

What better addition to your office knick knacks than a Lego Minifig anesthesiologist. Unfortunately, the only available minifigs are generic doctors; no accessories are available to indicate our noble profession. I started with the Lego “surgeon” minifig and planned to create my own Lego sized laryngoscope. I found a 3D model on Thingiverse by user Mvetto labelled laryngoscope pendant to start with. I edited the proportions to fit a minifig hand and exaggerated the size of the blade to make it the model somewhat comical. Here is the result, a custom anesthesiologist minifig. 


You can find the minifig on Amazon: Link

If you’re interested in anesthesia and operating room lego builds, the flickr account of canadian anesthesiologist Lucie Filteau has some really cool setups: Here

Large esophagus on laryngoscopy.

The following was encountered while intubating a 50 year old male with a history of neck radiation for the treatment of esophageal cancer and resection of his epiglottis and tongue base. The patient was 20 hours NPO and denied any history suggestive of active esophageal pathology.


We optimized airway positioning with external laryngeal manipulation and placed an endotracheal tube over a gum bougie and continued to the patient’s unrelated orthopedic fixation.

Incidental Supraglottic Lipoma

We induced a healthy 45 year old female for cholecystectomy for a history a biliary colic. The patient had an unremarkable airway exam and denied any abnormal ENT symptomatology. After induction the junior resident mentioned “confusing” anatomy on direct laryngoscopy; we performed video laryngoscopy to investigate producing the following images:


We obtained an intraoperative ENT consult and they suspected that it was a lipoma. Since the lesion would not compromise the airway, the ENT team elected to perform a biopsy at a later date so that the patient could be properly consented for the procedure.

The patient was seen in ENT clinic the following week and a surgical excision was performed the following month uneventfully. Pathologic examination confirmed it to be a lipoma as expected.