Awake tracheal intubation for blunt airway trauma

A 64-year-old man sustained blunt trauma to the anterior neck following a mechanical fall resulting in an isolated laryngeal fracture of the left cricoarytenoid complex. Although there was no acute airway compromise, he developed worsening airway oedema which necessitated tracheal intubation. He underwent oral awake tracheal intubation with a flexible bronchoscope to facilitate formation of a tracheostomy under general anaesthesia. The challenges encountered in the clinical management of this case relate to decision making for the patient with airway trauma in the absence of the need for emergency tracheal intubation. We describe the advantages and pitfalls of various airway management strategies in the context of blunt airway trauma.