Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 07 786 789 Reza Tahmasabi Department of Anesthesia, Hamadan University of Medical Sciences, Hamedan, Iran. Ibrahim mouhamad Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. Pegah Arman Department of Anesthesiology, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran. Afshin Farhanchi Department of Anesthesia, Hamadan University of Medical Sciences, Hamedan, Iran. 2024 12 24 2025 01 08 A 68-year-old female patient referred for mandibular reconstruction surgery. He was treated for cancer in the mandible last month. Due to the extent of the mass in the lower jaw area, this patient underwent Mandibulectomy 9 months ago. The patient was admitted to Ba'ath Hospital in Hamadan, his vital signs were stable. Before the surgery, according to his underlying diseases, a cardiovascular consultation was done and no complications affecting anesthesia were reported. The challenge of the anesthesia team in this patient was to establish a safe airway for him. According to the physical condition of the patient's neck and mandible, the patient was intubated using a Fireoptic bronchoscope. The patient's surgery lasted 2 hours and 45 minutes. During the entire period of anesthesia, the patient was under strict respiratory monitoring. After the end of the surgery, the patient was transferred to the recovery room without removing the endotracheal tube, and after ensuring that the patient's condition was stable, he was transferred to the intensive care unit. https://aacc.tums.ac.ir/index.php/aacc/article/view/1164