The impact of neck flexion on ventilation and glottic visualisation in a child with Treacher Collins syndrome

We report the airway management of an 11-year-old boy with Treacher Collins syndrome. In three instances under general anaesthesia, ventilation via either anaesthesia facemask or supraglottic airway device proved virtually impossible except when the neck was flexed, which runs counter to what is typically observed during routine anaesthetic care. In this report, the impact of neck flexion on the patient's airway is demonstrated with images obtained on videolaryngoscopy and flexible endoscopy. It is prudent to manage airways using validated techniques and established algorithms. Nonetheless, airway management can benefit from atypical measures.