This case report highlights the use of elective front-of-neck access (FONA) as a proactive escape strategy in a child with a massive oropharyngeal tumour threatening complete airway loss. An 8-year-old presented with a large tonsillar mass causing choking, drooling, and radiologically confirmed critical airway narrowing. Anticipating a cannot-intubate cannot-oxygenate (CICO) scenario, the team pre-marked FONA landmarks and maintained spontaneous ventilation throughout induction.
Following failed video-laryngoscopic attempts, a rapid needle cricothyroidotomy with flow-controlled ventilation stabilized the child until a tracheostomy enabled surgical excision. The case underscores the importance of early recognition, pre-emptive planning, and elective FONA as a safe bridging technique in anticipated paediatric airway obstruction. To dive deeper into this rare yet high-stakes paediatric…
