cannot ventilate cannot intubate scenario in a five years old girl

Difficult airway is defined as situation that face mask ventilation, laryngoscopy, or intubation cannot be done by clinician as easy as he expects where it. difficulties in children airway management do not occur frequently and aggressive airway management in children is not required often. we present a case of “cannot ventilate, cannot intubate” scenario in a five years old girl with a supraglottic cyst in operating room. we started to sedate the patient with ketamine for awake intubation but the cyst obstructed the airway and we couldn’t ventilate her with mask. two try of intubation with tube and bougie were failed and rigid bronchoscope could maintain the airway finally.