G. Harinath1, G. Venkateshwarlu2, M. Bhanu Lakshmi3, G. Ramesh4, A. Mrunalini5
Nasal route of intubation is commonly used for surgical procedures involving Head and Neck, Patients with intra-oral pathology, structural abnormalities, trismus, cervical spine instability, cervical spine disease and OSA. The intubation may be aided by direct laryngoscopy, flexible fibreoptic laryngoscopy or by blind technique. The classical technique of blind nasal intubation requires a spontaneously breathing patient and uses breath sounds to guide placement. Most common complication associated with this technique is epistaxis. Other rare complications include - Inferior turbinate avulsion, middle turbinate/nasal polyp/tumour avulsion, Bacteraemia, Retropharyngeal mucosa dissection/laceration. Here we present to you a case of fracture mandible posted for ORIF for which blind nasal intubation was planned. While attempting the intubation the endotracheal tube coursed behind the retropharyngeal mucosa for a short distance before entering the trachea. Post-operatively the patient was put on Ryle’s tube feeding for 3 days followed by orals. The track healed spontaneously and the recovery was uneventful.
