# Challenges in Extubation: A Case of a Non-removable Tracheal Tube Following Surgery

## TL;DR

This case report describes a difficult extubation situation after surgery and emphasizes the importance of teamwork and alternative strategies in managing such challenges.

## Contribution

The paper presents a rare clinical case and offers practical guidance for managing difficult extubation without otolaryngology support.

## Key findings

- A lodged tracheal tube was resolved with otolaryngology assistance after failed deflation attempts.
- The case highlights the need for multidisciplinary collaboration in complex extubation scenarios.
- Alternative strategies are proposed for managing difficult extubation when otolaryngology is unavailable.

## Abstract

This report details a challenging case of difficult extubation due to a lodged tracheal tube following surgery, presenting an unexpected and complex clinical situation. An inspection of the airway using videolaryngoscopy revealed an over-inflated cuff beneath the vocal cords. Initial efforts to deflate the cuff with various methods were unsuccessful. The situation was ultimately resolved through the intervention of an otolaryngology surgeon. This case not only reviews various mechanisms of difficult endotracheal tube removal reported in the literature, but also underscores the potential for serious complications and highlights the critical role of multidisciplinary collaboration in managing extubation challenges. Additionally, our manuscript discusses alternative strategies that can be employed in scenarios where an otolaryngology surgeon is not available, offering practical guidance for anesthesiologists confronted with similar situations.