Unexpected challenge: Proseal insertion and intubation complicated by undiagnosed aryepiglottic fold cyst

Airway management has always been the main stay of concern for all Anaesthetists especially when it is an undiagnosed difficult one. Our main stay of the article is to be prepared with all forms of equipment for any and all difficult airways, difficult airway can turn into a nightmare for any anaesthesiologist. Vallecular or aryepiglottic fold cysts are often asymptomatic and harmless as long as they do not cause airway narrowing.To discover a vallecular or aryepiglottic fold cyst after induction of anesthesia on direct laryngoscopy is a potentially life-threatening problem as it involves a challenge for the anaesthesiologist. This report describes the management of a patient with an asymptomatic vallecular cyst that was discovered during inability to ventilate after proseal insertion and visualised with laryngoscopy, prior to which the patient did not present with any airway symptoms even after anesthesia induction and muscle relaxant.