Tracheal intubation through the intubating laryngeal mask in a patient with a fixed flexed neck and deviated larynx

Insertion of the conventional laryngeal mask is more difficult or impossibl e when the patient's head and neck are in either the neutral or flexed posi tion. The intubating laryngeal mask is best inserted when the patient's hea d is supported by a pillow without placing the head and neck into the Magil l position; therefore, insertion of this modified mask may be less difficul t than the conventional mask in the patient with a flexed neck. We report a case of successful insertion of the intubating laryngeal mask and subseque nt tracheal intubation through the mask using a fibre-optic bronchoscope, i n a patient with a flexed neck in whom tracheal intubation using several me thods had been difficult previously.