Lingual Traction and the Lateral Decubitus Position Facilitate Awake Fiberoptic Oral Intubation in a Patient With Ehlers-Danlos Syndrome (Hypermobile Type) and Craniocervical Fixation: A Case Report.

Background: Awake fiberoptic intubation (AFOI) remains the preferred technique for anticipated difficult airway management. However, severe restriction of mouth opening, fixed craniocervical anatomy, and sedation-induced hypopharyngeal collapse may substantially impair endoscopic visualization and increase procedural difficulty. Simple mechanical maneuvers that improve upper airway patency may facilitate successful intubation in these highly challenging patients. Case Presentation: We report the airway management of a 24-year-old woman with Ehlers-Danlos-hypermobile type (EDS-HT) syndrome, previous craniocervical fusion, severe temporomandibular dysfunction, and a history of a prior Conclusion: This case illustrates that combining lingual traction with lateral decubitus positioning can mechanically optimize upper airway patency during AFOI in patients with fixed craniocervical anatomy and EDS-HT patients. These simple, low-cost, and readily reproducible maneuvers may represent valuable adjuncts when conventional airway techniques are limited or contraindicated.