Difficult tracheostomy tube placement to neck breather with chronic stenosis after total laryngectomy

As neck breathers have been proven to improve life expectancy, the chance of requiring neck breathing treatment is increasing. A 75-year-old man with a history of total laryngectomy in 1995 for laryngeal cancer was diagnosed with mechanical obstruction due to colorectal cancer. Emergency Hartmann’s operation was performed. We pre-evaluated a narrow stoma airway measuring 5 mm with chronic stenosis. Anesthesia was successfully induced using a 4.5-mm tube with a fiberoptic scope. After stomaplasty, we converted to a 7.0-mm tube. Moreover, we pre-evaluated the neck breather’s airway, and planned how to induce anesthesia and cope with emergency situations.