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  • Title: Fluoroscope-aided retrograde placement of guide wire for tracheal intubation in patients with limited mouth opening.
    Author: Biswas BK, Bhattacharyya P, Joshi S, Tuladhar UR, Baniwal S.
    Journal: Br J Anaesth; 2005 Jan; 94(1):128-31. PubMed ID: 15485999.
    Abstract:
    Passing a retrograde catheter/wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fibre-optic bronchoscope or an expert user of such a device is not available. Some mouth opening is essential for the oral and/or nasal retrieval of the catheter/wire from the pharynx. Two patients with temporo-mandibular joint (TMJ) ankylosis and extremely limited mouth opening required gap arthroplasty of the TMJ under general anaesthesia. Because we did not have a flexible fibre-optic bronchoscope, we performed fluoroscopy-assisted nasal retrieval of the guide wire passed up through a cricothyroid puncture and subsequently accomplished wire-guided naso-tracheal intubation. In the absence of a flexible fibre-optic bronchoscope, this technique is a very useful aid to intubation in patients with limited mouth opening.
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