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Updated: Jan 7, 2026

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
Laryngospasm Complicating Awake Nasal Intubation in Ludwig's Angina
Sara Onuki1, Yoshihiro Hayakawa1, Naoki Yonezawa1
1Department of Emergency and Critical Care Medicine Yokohama City Minato Red Cross Hospital Yokohama Kanagawa Japan.
Abstract:
A 64-year-old man with Ludwig's angina developed laryngospasm during awake fiberoptic intubation despite mild supraglottic edema. Paralysis restored ventilation and allowed successful intubation. This case illustrates that even minimal laryngeal inflammation can trigger reflex airway closure, underscoring the need for preparedness for failed awake intubation and potential surgical airway intervention.
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