Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 4 2025 02 18 599 602 Nahid Manoucherian Department of Anesthesiology, Hamadan University of Medical Sciences, Hamadan, Iran. Pegah Arman Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. Parastoo Rahmati Torkashvand Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran. Younes Barazesh Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. 2024 11 04 2024 11 30 A 45-year-old male patient was diagnosed with papillary thyroid cancer and was scheduled for total thyroidectomy. Three months before, he had undergone laryngeal surgery for squamous cell carcinoma of the larynx. Before the operation, an internal consultation was performed and no respiratory or cardiac complications were reported. Upon visiting Besat Hospital, the patient's vital signs were stable. Establishing a safe airway due to tracheostomy breathing was a challenge. But after consultation with the anesthesia team, the endotracheal tube was successfully inserted. This surgery lasted for 5.5 hours smoothly and without complications. The patient was transferred to the intensive care unit after the operation and was discharged in a stable condition after recovery. https://aacc.tums.ac.ir/index.php/aacc/article/view/1121