Nasal Retrograde Intubation in Oromaxillofacial Surgery Patients with Limited Mouth Opening: A Cross-sectional Study

  • Ambrish Kumar Bhagwan Mahavir Medica Superspecialty Hospital, Ranchi, Jharkhand, India
Keywords: Intubation, Limited mouth opening, Maxillofacial surgery, Nasotracheal retrograde intubation


Introduction: Retrograde intubation is an alternative technique of securing definitive airway in the patients with limited mouth
opening (LMO) when blind nasal intubation fails, and fiber-optic bronchoscope is unavailable. Retrograde intubation in patients
with LMO <2 cm through nasal route is an alternative method for airway management.
Materials and Methods: The procedure was performed on 36 patients requiring maxillofacial surgical procedures to increase
mouth opening. Indication for this technique was oral mucous fibrosis (OSMF; n = 12), temporomandibular joint (TMJ) ankylosis
(n = 8), mandibular fracture (n = 12), and derangement of TMJ (n = 4). All patients were examined for pre-operative interincisal
opening; during intubation through specific parameters and also post-operative findings were observed.
Results: The mean time was 5.6 min in successfully intubated patients. Eight patients had sore throat which resolved in few
days and two patients had subcutaneous emphysema managed conservatively. No other complications were detected.
Conclusion: Retrograde nasotracheal intubation is an effective and useful technique for airway management in LMO patients
with minimal risk.

Author Biography

Ambrish Kumar, Bhagwan Mahavir Medica Superspecialty Hospital, Ranchi, Jharkhand, India

Department of ENT, 


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