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A 68-year-old patient with a huge dangling vocal papilloma was admitted for surgical resection. Preoperative data regarding the patient’s mass-related symptoms, endoscopic view, and radiological evaluation indicated that airway management would be difficult. Fiberoptic intubation has been considered an ideal primary approach to managing problematic airways, but blind advancement of the endotracheal tube without a clear, consistent view of the mass presents a significant threat to patient safety. This report describes how safe intubation was accomplished while the patient was awake using laryngeal nerve blocks and a McGrath® videolaryngoscope.