Abordagem de via aérea difícil em paciente com patologia de cabeça e pescoço

Difficult airway (DA) remains a challenge in anesthetic practice, particularly in patients with head and neck pathologies leading to anatomical alterations. We report the case of a 40-year-old male with severe cardiac comorbidities and craniofacial malformations (cleft palate and macrognathia), undergoing transfemoral amputation. Two attempts at orotracheal intubation failed, requiring successful nasotracheal intubation with videolaryngoscope. This case highlights the importance of detailed pre-anesthetic assessment, individualized planning, and the use of advanced devices such as videolaryngoscope, bougie and fiberscope for safe management of DA. We conclude that early recognition of risk factors and the adoption of alternative strategies are essential to reduce complications and ensure patient safety.