Unexpected tracheal web encountered during difficult intubation in the operating room.

A 60-year-old woman was prepared for revision of a previous anterior lumbar interbody fusion. After induction of anesthesia, three attempts to pass decreasing sizes of endotracheal tubes remained unsuccessful. An LMA Fastrach was inserted to maintain ventilation. Upon examination of the trachea with a flexible fiberoptic bronchoscope via the LMA Fastrach, a tracheal web was visualized 1 cm below the true vocal cords. Intraoperative excision of the tracheal web by an otolaryngologist allowed for the passage of an endotracheal tube and the continuation of the planned surgery.