Fiberoptic Reintubation in an Unanticipated Difficult Airway: A Case Report.

Authors

Alireza Nikzad-Jamnani, Seyyed Alireza Seyyed Siamdoust, Seyyed Javad Boskabadi, Sima Ramezaninejad, Saeed Kargar-Soleimanabad

Published in

Case reports in anesthesiology. Volume 2026. Pages 9811616. Epub Jul 29, 2026.

Abstract

Although direct laryngoscopy may seem the most reasonable modality for previously intubated patients, in the setting of anatomical distortion secondary to reconstructive neck surgery, flexible fiberpostoptic laryngoscopy (FFL) should be considered for patients who may require postoperative emergency reintubation.
A 51-year-old woman with squamous cell carcinoma of the submental triangle and larynx was referred for free flap surgery. For postoperative care, she was admitted to the ICU. After 18 h, the patient developed respiratory distress and confusion. We decided to perform awake tracheal intubation for her. After receiving a sufficient dose of fentanyl and dexmedetomidine, intubation with direct laryngoscopy was attempted, but it failed. Fortunately, the patient was intubated using an FFL available in the ICU. After 48 h, she was extubated and transferred to the surgery ward.
Our experience suggests that, for patients who are undergoing free flap surgery in regions that jeopardize the airway, if intubation is needed (especially shortly after surgery), difficult airway management devices such as FFL should be readily accessible alongside an expert anesthesiologist.

PMID:
42534391
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.