We report an alternative approach to intubation which a gum elastic bougie (GEB) is used to facilitate an anticipated difficult endotracheal intubation in a patient undergoing thyroidectomy due to nodular goitre in a patient with hemangioma of upper lip lying to hard and soft palate and left mandibular mass. It was considered as difficult intubation after a careful preoperative evaluation. GEB was inserted through to the trachea with palpations tracheal cartilages after an unsuccessful try of intubation. Hereby intubation tube was easily placed to trachea. GEB can be used effectively in difficult intubation due to congenital anomalies like orofacial hemangioma.
Keywords: Orofacial, hemangioma, goiter, intubation, difficult airway