RESUMO
Objective: To describe the technical aspects of emergency tracheostomy in a case of extensive neck swelling with a challenging airway. Methods: We report a case of difficult tracheostomy in a patient with a huge neck swelling causing obscured anatomical landmarks in significant stridor. A literature review was performed to identify similar cases or techniques. Results: Emergency tracheostomy was successfully executed with the help of clinical acumen, imaging findings and intra-operative ultrasound usage. Conclusions: We describe a safe and effective technique of emergency tracheostomy in patients with huge neck swelling and obscured anatomical landmarks. Collaboration of surgeon with the anaesthesia service is of paramount importance in dealing with challenging airways.