An unanticipated difficult airway is a great challenge for an anaesthesiologist especially when general anesthesia and N-M blocking agent has already being administered at the time of induction. In this case of carcinoma larynx, on laryngoscopy vocal cord chink was found to be v small and it was impossible to intubate the trachea even with smaller ETT .We used a ventilating tube exchanger catheter in emergency situation to oxygenate and ventilate the lungs and with the help of zero degreeoral

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... doscope, which was available with ENT surgeons, we could manage to intubate trachea with ETT size 6.5 cuff tube and got biopsy done.