Awake tracheal intubation with the intubating laryngeal mask in a patient with diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis, otherwise known as Forestier's di sease or ankylosing hyperostosis, is a relatively common condition that is distinguished hom ankylosing spondylitis by the relative preservation of sp inal function and the characteristic 'candle flame' lipping of the vertebra e. We report a patient with this condition and a well-recorded history of i mpossible intubation who presented for emergency laparotomy. The patient wa s intubated awake using the intubating laryngeal mask and sedation and anae sthesia were provided by a target-controlled infusion of propofol.