[Unexpected expectable difficult airway : every anesthesia is different]

The case of a female patient is reported where difficulty in securing the airway occurred during a reconstructive intervention following partial mandibular resection. During previous surgery the last of which was 2 months prior to this, endotracheal intubation was carried out with the GlideScope videolaryngoscope, but now the vocal chords could not be viewed with the GlideScope. Attempts at fiber optic intubation under general anesthesia were also unsuccessful. A "cannot ventilate, cannot intubate" situation ensued and an emergency tracheotomy was carried out. The case described makes it clear that neither modern devices nor experience from previous anesthesia can reliably guarantee a safe airway management.