Retromolar Approach for Tracheal Intubation: Rescue Technique in a Rare Case of Hard Palate Cyst- A Case Report
Vol 8 | Issue 2 | May-August 2022 | Page: 16-18 | Swati Bharti, Ruchi Kapoor, Akanksha Rathore, Sujata Chaudhary
Author: Swati Bharti , Ruchi Kapoor , Akanksha Rathore , Sujata Chaudhary 
 Department of Anaesthesiology, Critical Care and Pain Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Address of Correspondence
Dr. Swati Bharti
Department of Anaesthesiology, Critical Care and Pain Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Introduction: Presence of an intraoral swelling may pose difficulty in laryngoscopy, glottic visualisation and endotracheal intubation using the conventional Mcintosh laryngoscopy. Not only does the mass anatomically hampers the laryngoscopy but also there is risk of trauma to the mass which may bleed and create further difficulty in securing the airway.
Case presentation: An 18-year-old boy presented to us for excision of a mass arising from hard palate since 1½ years. CECT PNS was suggestive of large well-defined lytic expansile area seen in upper alveolus and adjacent hard palate extending into the anterior part of nasal cavity abutting bilateral inferior turbinate and obliterating anterior part of nasal cavity thus a contraindication for nasal intubation. On airway examination, mouth opening was adequate with MPC 1, loose upper incisors, 3×3 cm swelling on hard palate and decreased nasal patency. As the surgeon had to operate in the midline, therefore a plan for retromolar intubation was made to secure the airway using paraglossal approach for direct laryngoscopy with a Millers blade keeping in mind that endotracheal tube shouldn’t interfere in the operative field.
Conclusion: Retromolar intubation can be used successfully for securing airway for surgical procedures in oral cavity when nasotracheal intubation is not possible, and surgical access to airway is best avoided.
Keywords: Retromolar tracheal intubation, Midline hard palate cyst, Airway management
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|How to Cite this Article: Bharti S, Kapoor R, Rathore A, Chaudhary S | Retromolar Approach for Tracheal Intubation: Rescue Technique in a Rare Case of Hard Palate Cyst- A Case Report | Journal of Anaesthesia and Critical Care Case Reports | May-August 2022; 8(2): 16-18.|
Tags: airway management, Midline hard palate cyst, Retromolar tracheal intubation