Cuff Inflation Technique During Fiberoptic Nasal Intubation in Patients With Limited Mouth Opening

Airway management is critical, particularly in patients who undergo oral maxillofacial surgery, and often involves use of nasotracheal intubation which can be difficult. We previously described a technique involving use of a flexible fiberoptic scope to provide continuous indirect vision of the endotracheal tube (ETT) tip and the glottis to assist with successful advancement of the ETT during nasotracheal intubation. Nevertheless, we often have experienced difficulties during intubation using this method as spatial manipulation and direction of the nasal ETT into the trachea may occasionally be difficult. In such cases, combining visualization with the flexible fiberoptic scope along with the cuff inflation technique may be useful to aid manipulation of the ETT, unlike the technique previously combined with a video laryngoscope. We describe this clinical technique which may be used during fiberoptic nasal intubations to help increase success securing the airway.