Awake Blind Nasal Intubation as an Alternative to Fibreoptic Intubation

Temporomandibular joint (TMJ) ankylosis is a pathological condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with the mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency. Though it is not common, is an anaesthetic challenge, as it is a difficult airway situation with a moderate to a severely limited mouth opening. Fiber optic intubation is a gold standard for such cases, but it may not be readily available at all centers. Blind nasal intubation, Retrograde intubation and tracheostomy are the other alternatives, but they require patient cooperation and are associated with considerable morbidity. We are presenting a case of TMJ ankylosis which is not taken for anaesthesia in many of the corporate and tertiary centers. She was blind nasally Intubated, maintained and extubated successfully.