AÇBİD 2024, Antalya, Turkey, 10 - 14 May 2024, no.60, pp.61
anesthesia practice. Among the various specialized tools, fiberoptic bronchoscopy (FOB)
emerges as the only option especially in patients with limited mouth opening, Therefore, the
ability to use FOB quickly and effectively becomes crucial.
Case: A 39-year-old male patient with TMJ ankylosis developed following a previous trauma
was scheduled for bilateral gap arthroplasty. As direct laryngoscopy or videolaryngoscopy was
not possible due to the restricted mouth opening, nasotracheal intubation with the aid of FOB
was planned. Unlike the conventional method which includes the introducing the bronchoscope
first and then the intubation tube, a modified method was performed in an attempt to minimize
the contact with blood and secretions. In this case, the intubation tube was first passed through
the nasal cavity in a controlled manner, then, the tube was used as a guide to advance the FOB
through the nasal cavity.
Conclusion: Passing the endotracheal tube through the nasal cavity before FOB may provide
a faster and more effective intubation in cases with difficult airways.