Airway Management Challenges in Three Cases of Vallecular Cysts.

Vallecular cysts, though rare in adults, can pose significant challenges to anesthetic management due to their location near the airway and potential for life-threatening complications such as airway obstruction, aspiration, or cyst rupture during intubation. This case series presents three adult male patients who reported with symptoms ranging from dysphagia and voice changes to globus sensation, each diagnosed with vallecular cysts via imaging and endoscopic evaluation. All patients underwent surgical excision under general anesthesia following awake fiberoptic intubation (AFOI) to avoid airway compromise. Preoperative preparation involved comprehensive airway assessment, regional airway blocks, topical anesthesia, and conscious sedation. Anesthesia was successfully maintained with balanced agents, and each surgery concluded without intraoperative or postoperative complications. These cases underscore the importance of meticulous preoperative planning, individualized airway strategies, and use of AFOI in patients with potentially obstructive vallecular cysts. Such tailored approaches are critical for safe and effective anesthetic management in these high-risk scenarios.