Nasotracheal intubation by fiberoptic laryngoscope

We have presented a case in which the fiberoptic laryngoscope was used for nasotracheal intubation, an alternative for the difficult laryngoscopy. We believe regional blocks combined with extensive topical anesthesia aid in the successful use of the fiberoptic laryngoscope for cases of difficult intubation in the practice of oral surgery. We were unable to obtain a complete sensory block with benzocaine or lidocaine spray since the mouth opening was less tha 1 mm. The bilateral superior laryngeal nerve block is a valuable adjunct to the procedure.