<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:An obese 52-year-old man is brought to the emergency department because of increasing shortness of breath for the past 8 hours. Two months ago, he noticed a mass on the right side of his neck and was diagnosed with laryngeal cancer. He has smoked two packs of cigarettes daily for 27 years. He drinks two pints of rum daily. He appears ill. He is oriented to person, place, and time. His temperature is 37C 98.6F, pulse is 111min, respirations are 34min, and blood pressure is 14090 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 89. Examination shows a 9-cm, tender, firm subglottic mass on the right side of the neck. Cervical lymphadenopathy is present. His breathing is labored and he has audible inspiratory stridor but is able to answer questions. The lungs are clear to auscultation. Arterial blood gas analysis on room air shows:pH 7.36PCO2 45 mm HgPO2 74 mm HgHCO3- 25 mEqLHe has no advanced directive. Which of the following is the most appropriate next step in management?? A: Tracheal stenting, B: Tracheostomy, C: Intramuscular epinephrine, D: Comfort care measures, E: Cricothyroidotomy,  <response>: This is a clinical vignette about a 52-year-old obese man with laryngeal cancer who presents to the emergency department with shortness of breath. Key findings include a 9 cm neck mass causing stridor and hypoxemia. The question is asking for the most appropriate next step in management.Based on the patients severe respiratory distress with stridor and hypoxemia, securing his airway is the top priority. Tracheostomy and cricothyroidotomy are invasive but may be necessary. Epinephrine and tracheal stenting may temporarily improve airflow but do not definitively secure the airway. Comfort care measures alone are not appropriate given the acute respiratory distress.B: Tracheostomy 