Pharyngoplasty: a hazard for nasotracheal intubation

General anaesthesia is desirable for a wide range of oral and maxillofacial operations and nasal intubation is essential for some procedures, particularly orthognathic surgery. The patient who has undergone pharyngoplasty presents with a reduced velopharyngeal orifice which may interfere with the insertion of the nasal tube. It is suggested that nasal pharyngoscopy or a similar investigation should be included as part of the preoperative assessment for these patients if nasotracheal intubation is anticipated.