Anticipated difficult intubation due to intraoral lipomatous polyp

Anticipated difficult intubation if not planned meticulously can be challenging to a anesthesiologist. We describe a successful management of a case of anticipated difficult intubation due to a rare intra oral lipomatous polyp arising from the posterior pharyngeal wall. We use levering McCoy laryngoscope for intuabting trachea because we failed to intubate with conventional MacIntosh laryngoscope in first attempt and for fear of complete airway obstruction dexmedetomidine infusion was used for sedation. In our case we relied on radiological imaging for assessment of difficult airways. So managing each case is highly unique, individualized and no technique is obsolete in managing difficult airways even with a unavailability of modern aids.