Journal of Maxillofacial and Oral Surgery

, Volume 17, Issue 4, pp 439–440 | Cite as

Tracheal Tube Blockage by Fractured Middle Turbinate During Nasal Intubation: A Rare Airway Complication

  • Praveen Satish KumarEmail author
  • Francis Akkara
  • Vikas Dhupar
Case Report


Nasotracheal intubation is the preferred method of securing airway in patients undergoing maxillofacial and oral surgical procedures [1]. Nasotracheal intubation can potentially cause nasal damage, sinusitis [2] and local abscesses. Some of the contraindications to nasotracheal intubation include suspected epiglottitis, midface instability, suspected basilar skull fractures, large nasal polyps and coagulopathy. We report a case in which fracture of the middle turbinate caused inadvertent blockage of tracheal tube lumen during intubation in a maxillofacial patient causing airway emergency.

Case Report

A 26-year-old male patient was to undergo open reduction and internal fixation of left zygomatico maxillary complex fracture under general anesthesia via nasotracheal intubation. The pre-anesthetic evaluation performed by the anesthesiologist did not reveal any abnormalities which could contraindicate the nasal intubation. So general anesthesia was induced, and after adequate...


Compliance with Ethical Standards

Conflict of interest



  1. 1.
    Kwak HJ, Lee SY, Lee SY, Cho SH, Kim HS, Kim JY (2015) McGrath video laryngoscopy facilitates routine nasotracheal intubation in patients undergoing oral and maxillofacial surgery: a comparison with Macintosh laryngoscopy. J Oral Maxillofac Surg 74(2):256–261PubMedCrossRefGoogle Scholar
  2. 2.
    O’Reilly MJ, Reddick EJ, Black W et al (1984) Sepsis from sinusitis in nasotracheally intubated patients. A diagnostic dilemma. Am J Surg 147(5):601–604PubMedCrossRefGoogle Scholar
  3. 3.
    McDonnell NJ, Paech MJ, Clavisi OM, Scott KL (2008) Difficult and failed intubation in obstetric anaesthesia: an observational study of airway management and complications associated with general anaesthesia for caesarean section. Int J Obstet Anesth 17:292–297PubMedCrossRefGoogle Scholar
  4. 4.
    Rodriguez PMA, Conde SMP, Lopez RJM, Hernandez F, Casado PJ, Muriel-Villoria C (2008) Endotracheal tube obstruction secondary to oral medication. Eur J Anaesthesiol 25:598–599CrossRefGoogle Scholar
  5. 5.
    Haldar R, Samantha S, Bhagat H (2013) Unexpected tracheal tube blockage from a semi-dissolved misoprostol tablet. Int J Obstet Anesth 22(3):267–268PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2017

Authors and Affiliations

  • Praveen Satish Kumar
    • 1
    Email author
  • Francis Akkara
    • 1
  • Vikas Dhupar
    • 1
  1. 1.Department of OMFSGDCHBambolimIndia

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