[Failed intubation with case reports]

Failed intubation in three patients is reported. All three patients suffered sudden, extreme impaired of mask-ventilation. Twice a coniotomy with subsequent tracheostomy proved to be life saving and without permanent injury. In the other patient tracheostomy had been attempted without success, and subsequent, successful, coniotomy could not prevent cerebral ischemia. Coniotomy is the only correct emergency operation for failed intubation with impaired mask ventilation. It must be followed by a standard tracheostomy with closure of the coniotomy wound to prevent permanent laryngeal damage.