The elective use of percutaneous transtracheal oxygen insufflation for laryngeal surgery in a patient with a known difficult airway.

We report the case of successful elective percutaneous transtracheal oxygen insufflation in a patient with high-grade laryngeal stenosis, requiring repeat surgical laryngeal dilation, in the setting of multiple previous failed attempts at intubation and ventilation. This case report highlights the role of this technique as an initial management plan to provide general anaesthesia in a safe and simple way to patients with a known difficult airway. We also describe the use of an intravenous extension kit which allowed end-tidal carbon dioxide to be measured during transtracheal oxygen insufflation.