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From the Department of Anesthesiology, School of Medicine, Medical Sciences/University of Tehran, Imam Khomeni Medical Center, Tehran, Iran.
Address correspondence and reprint requests to Zahid Hussain Khan, MD, Department of Anesthesiology, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Keshavarz Blvd., Tehran 14197, Iran. Address e-mail to khanhzh51{at}yahoo.com.
A 31-yr-old woman with concurrent Cushing's and Nelson's syndromes was scheduled for transsphenoidal hypophysectomy. The patient had generalized edema, morbid obesity, and a history of sleep apnea. Her Mallampati assessment was Class 4, suggesting very difficult intubation, but the upper lip bite test predicted easy intubation. After rapid sequence induction, there was a Class 1 view on laryngoscopy, and intubation was accomplished easily.
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