Head and neck cancer recurrence with limited mouth opening, radiation fibrosis and confirmed COVID-19 infection: approach to airway management Authors Faisal Shamim Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan https://orcid.org/0000-0001-5504-8341 Muhammad Sohaib Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan Kashaf Shahid Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan Syed Akbar Abbas Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan DOI: https://doi.org/10.47391/JPMA.5588 Abstract We present a case that describes the airway management of a patient with recurrent head and neck cancer and confirmed COVID-19 infection. Securing airway of these patients with anticipated difficulty and at the same time limiting virus exposure to providers can be challenging. The risk of aerosolization during awake tracheal intubation is extreme as it carries a high risk of transmitting respiratory infections. A multidisciplinary team discussion before the procedure highlighted aspects of both airway management and the urgency of surgical procedure where particular care and modifications are required. Successful flexible bronchoscopy and intubation was done under inhalational anaesthetics with spontaneous breathing. Although fiberoptic intubation during sleep,in anticipated difficult airways, have led to enhanced intubation time, this technique was opted to minimize the risk of aerosol generation associated with topicalisation, coughing and hence reduced incidence of cross infection to health care workers. Author Biographies Faisal Shamim, Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan Department of Anaesthesiology Associate Professor Muhammad Sohaib, Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan Department of Anaesthesiology Assistant Professor Kashaf Shahid, Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan Department of Anaesthesiology Resident Syed Akbar Abbas, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan Department of Surgery Assistant Professor Downloads Full Text Article Published 2023-03-15 How to Cite Shamim, F., Sohaib, M., Shahid, K., & Abbas, S. A. (2023). Head and neck cancer recurrence with limited mouth opening, radiation fibrosis and confirmed COVID-19 infection: approach to airway management. Journal of the Pakistan Medical Association, 73(4), 912–914. https://doi.org/10.47391/JPMA.5588 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 73 No. 4 (2023): April Section CASE REPORT License Copyright (c) 2023 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.