Airway Management through a Limited Oral Access: An Anaesthetic Hurdle in an Infant with Restricted Mouth Opening

Abstract The subglossopalatal membrane is a rare congenital anomaly of the intraoral cavity characterised by a membranous band extending from the floor of the mouth to the palate. Its presence can result in significant airway obstruction and feeding difficulty, often leading to recurrent infections and considerable weight loss in the affected infants. Surgical excision is the definitive treatment for this condition. These patients are mostly infants or neonates with limited intraoral space due to an enlarged tongue, and the presence of such a membrane further complicates the airway management. Performing excision under sedation poses a significant risk in this vulnerable group of patients; therefore, general anaesthesia is usually required. Flexible fibreoptic bronchoscope-guided endotracheal intubation is considered the gold standard for anticipated difficult airway. However, a meticulous and carefully planned approach is crucial, as any trauma during intubation in an already compromised airway can lead to serious complications.