We are going to report a neck contusion case with the internal swelling of laryngeal tissue, who needs to establish an emergency airway due to upper airway obstruction. There still remain some the blind points for the evaluation of difficult intubation. By using surgical cricothyroidectomy, we successfully maintain his airway, which is compatible with the difficult airway algorithm. In order to establish the airway rapidly, we should set up the portable difficult intubation unit in case of emergency occurred.