[Intraoperative management for two patients with malignant tumors in the neck]

We experienced two cases of malignant tumors in the neck with difficulties in airway control. In case 1, difficult airway was anticipated from the CT scan taken before the operation, but the glottis was observed easily by using laryngoscope. Therefore we judged intubation easy and rapid induction was performed, but the tube did not go in farther. When we pushed it in bleeding made the ventilation impossible, and the airway had to be ensured by tracheotomy. In case 2, difficult airway was anticipated from the CT scan. Making use of our experience in case 1, tracheotomy was performed under neuroleptanesthesia, but it was a too heavy burden for the patient. There are various methods of airway control and it is necessary for us to master the skills of them, but it is much safer to anticipate difficult airway by careful preoperative evaluation and manage accordingly than to find a way out of an emergency with these skills.