Nasal intubation in an adult male with Le Fort II fracture a
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We present here the difficulties encountered in an adult patient with Le Fort II fractures and head injury for open reduction/internal fixation of a mandible, which arose due to non-availability of an adult fibreoptic bronchoscope (FOB) and bougie. A patient had Glasgow coma scale score 15/15 with normal vitals, blood parameters and cervical spine. Computed tomography scan showed a small subdural hematoma and pneumocephalus in the right temporal region with no significant midline shift, Le Fort II fracture (left), bilateral fracture body and condyle mandible; comminuted fracture of frontal/maxillary sinuses, orbit and nasal septum, which was deviated to the right.Edematous inferior turbinates were seen bilaterally, left nasal passage diameter being grossly narrowed. Airway assessment revealed an interincisor distance of 1.5 cm with a complaint of pain in the jaw. The rest of the airway was normal....

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