Mandibular tori are intraoral bony prominences which can make direct laryngoscopic intubation difficult. We present a case where we were unable to intubate a patient with bilateral mandibular tori using direct laryngoscopy, but then succeeded using video laryngoscopy. A post-procedure retrospective chart review found previous anesthetics where the patient had also been successfully intubated using video laryngoscopy but the patient was not informed verbally or with a letter that he was difficult to intubate. We informed the patient that he was a difficult direct laryngoscopic intubation and that appropriate equipment (e.g. video laryngoscope) should be available if the need arises to secure his airway in the future. With the increasing availability of video laryngoscopy, anesthesia providers should consider the circumstances under which a patient is informed that they are difficult to intubate.
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