Treacher Collins Syndrome is a disorder of the first and second branchial arches in neural crest formation. It is caused by a mutation on chromosome 5 and has an incidence of 1 in 40000-70000 births. The syndrome is characterized by symmetrical hypoplasia of the maxilla, mandible, and zygomatic process. These individuals are likely to present with a small oral aperture, abnormalities of the temporomandibular joint, retrognathia and palate deformities. TCS is associated with difficult intubation, which has been demonstrated within a pediatric cohort to increase with age. Current literature does not contain a comprehensive review of airway difficulty and management amongst an adult TCS population-this is likely a reflection of the contemporary availability for pediatric corrective facial surgery. From the outset we suggest caution is applied to generalizing pediatric reviews towards adult patients, as airway features in syndromic patients inherently change with age. Previous case studies have demonstrated difficulty with intubation and found success in second generation laryngeal mask airways (LMA) amongst adult patients. Paloma used an LMA-Fastrach for an emergent caesarean section with no reported complications. Within this study blind intubation through the LMA was attempted, however was unsuccessful. An i-gel was successfully used as backup for Soh after two failed videolaryngoscopies and two failed trans-nasal fibreoptic intubations attempts for a 25-year-old male presenting for emergency bowel resection. The scholar journal uses editorial manager system for maintaining quality of the whole process of manuscript submission, peer review and tracking. Journal of Surgery and Anesthesia aims to maintain a rapid editorial procedure and a rigorous peer-review system for all the submitted manuscripts. The submitted articles are peer-reviewed within 21 days of submission and the accepted articles are published immediately. Acceptance of any manuscript for publication requires approval of at least two independent reviewers and the editor. Submit manuscripts as an e-mail attachment to manuscripts@longdom.org