Successful awake nasotracheal intubation using a fiberoptic bronchoscopy in a patient with impaired mouth opening due to temporomandiblar joint ankylosis

Temporomandibular joint ankylosis is a rare disease that characterized by mouth opening limitation, which causes problems with basic functions such as eating and breathing as well as anesthetic problems such as facial dysmorphism. Surgical treatment is essential to correct these disorders, but airway management during general anesthesia can be very challenging because difficult ventilation and intubation are anticipated. Fibroptic nasotracheal intubation is the gold standard, and it is important to plan and implement which nostril to access when actually doing it. We are presenting a case of a patient who successfully and safely underwent fibroptic bronchoscopy according to the intubation plan which supported by pre-operative CT and fibroptic laryngoscopy.