PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Case Series

Volume 7 Issue 2

Novel Ways to Navigate the Pediatric Difficult Airway; Troubleshoot the Obstruction, Triangulate your Positioning, Truncate the Handling; the 3T Approach, A Case Series

Farah Husain*, Sonia Wadhawan, Ramita Kashyap, Sukhyanti Kerai and Preeti Labani

January 29, 2026

Abstract

Children admitted to a hospital are extremely anxious about procedures such as intravenous drug administration, cannulation, dressings, surgeries etc. Given the inability of a child to cooperate during procedures, the possibility of securing a difficult airway in an awake child is therefore limited. Moreover, airway related challenges may occur intraoperatively which require prompt tailoring of our anesthesia technique. Hence, a meticulous and multidisciplinary planning is required to manage the difficult airway in the perioperative period.

We report the successful management of 3 paediatric difficult airway cases under general anesthesia using a novel, tailored approach; troubleshoot the obstruction to reach the trachea, using a triangulated positioning for laryngoscopy and intubation in extra oral tumours and truncate the surgical and airway handling to ensure smooth extubation. We call this the 3T approach to managing paediatric difficult airways.

Keywords: difficult airway; paediatric; anxiety; general anaesthesia; laryngoscopy; troubleshoot

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