[The intubating laryngeal mask for a patient with cerebrospinal fluid rhinorrhea and pneumocephalus].

A 53-year-old male was scheduled for repairs of cerebrospinal fluid (CSF) rhinorrhea and pneumocephalus under general anesthesia. He had undergone a neck clipping for a ruptured anterior communicating aneurysm 13 days before. As he had a difficult airway, Trachlight was used for successful tracheal intubation. To avoid tension pneumocephalus, an intubating laryngeal mask (ILM) was inserted with rapid sequence induction without positive pressure ventilation. A 7.0 mm ID straight silicone reinforced tube was then inserted through the ILM using a fiberscope. A fiberscope guided tracheal intubation via the ILM is recommended for patients with CSF rhinorrhea and pneumocephalus especially when the trachea is difficult to intubate under direct laryngoscopy.