A 60-year-old male patient was scheduled to operation for subtotal gastrectomy. Because his neck motion was limited due to tuberculous spondylitis, we decided to try awake bronchoscopic intubation. During oral application, the vocal cord was visualize...
A 60-year-old male patient was scheduled to operation for subtotal gastrectomy. Because his neck motion was limited due to tuberculous spondylitis, we decided to try awake bronchoscopic intubation. During oral application, the vocal cord was visualized but advancement of the endotracheal tube over the fiberoptic bronchoscope was failed because the tube impinged laryngeal structure. After several trials, we decided to perform nasotracheal intubation. After the tube was advanced through the nostril, bronchoscope was located above carina. Then the tube impinged laryngeal structure again, we rotated the tube 90° clockwise several times, finally the tube was advanced and located 2 cm above the carina. We report that fiberoptic nasotracheal intubation was more useful than orotracheal intubation in overcome `hang up` phenomenon in severe cervical kyphoscoliosis.