Frova Introducer in Anesthesiology: Friend or Foe?

The Frova Intubating Introducer is widely used in airway management, although it carries risks such as barotrauma and airway injury, especially when over-inserted (>26cm) or used for oxygen delivery (>2 L/min). We report a case of a 70-year-old woman with a substernal goiter and chronic obstructive pulmonary disease who developed bilateral pneumothorax, pneumomediastinum, and subcutaneous emphysema after open thyroidectomy and extubation over a Frova catheter. Emergent reintubation and chest drainage were required. Although a tracheal tear was suspected, it was not confirmed. The patient recovered fully with conservative treatment. Our report highlights the need for caution when using airway exchange catheters in patients with challenging anatomical airways and close post-extubation monitoring.