A case of post-radiation therapy patient with difficulty in intubation unexpected preoperatively

We experienced a post-radiation therapy patient who had a narrow trachea, and presented with unexpected difficulty for intubation. His trachea was narrowest at 2 cm below the glottis. The fiberscope barely could pass the narrowest part of the trachea. We speculate that the radiation therapy induced his tracheal constriction. Careful attention is necessary when examining the post-radiation therapy patients. Multiple cervical radiographs are necessary in such a case.