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GENERAL ARTICLES

Difficult Retrograde Endotracheal Intubation: The Utility of a Pharyngeal Loop

Departments of Anaesthesia & Intensive Care and *Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India

Address correspondence and reprint requests to Virendra K. Arya, MD, Assistant Professor, Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh-160012, India. Address e-mail to aryavk_99{at}yahoo.com

Direct laryngoscopy and tracheal intubation remains the technique of choice to achieve control of the airway. Alternative or additional techniques of airway control are required whenever an airway is deemed difficult because of anatomical and/or technical reasons. The retrograde intubation technique is an important option for gaining airway access from below the vocal cords in such situations (1).

We report successful management and the problems encountered while gaining the upper airway by the retrograde catheter method in a patient having bilateral fibrous ankylosis of the temporomandibular joint (TMJ).

IMPLICATIONS: A 30-yr-old woman presented for redo-release of bilateral temporomandibular joint ankylosis under general anesthesia. During the previous anesthetic for primary release of ankylosis, tracheostomy was done, as conventional blind nasotracheal and retrograde intubation attempts failed several times. This case report describes the method for overcoming the difficulties of a retrograde intubation procedure in removing the guiding catheter nasally by using a pharyngeal loop assembly.

This article has been cited by other articles:

				V. K. Arya, A. Kumar, S. S. Makkar, and R. K. Sharma Retrograde Submental Intubation After Faciomaxillary Trauma Anesth. Analg., December 1, 2005; 101(6): 1893 - 1894. [Full Text] [PDF]

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