SummaryUpper airway obstruction in cicatricial pemphigoid is rarely seen by the anaesthetist. A case of severe dyspnoea due to progressive laryngeal obstruction is presented. Tracheal intubation during induction of general anaesthesia .for permanent tracheostomy was extremely difficult and was successfully performed by introducing a size I2 French suction catheter through the stenotic laryngeal orifice. Adequate ventilation was achieved by using the oxygen Jlush valve to deliver oxygen intermittently through the catheter.

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