J Dent Anesth Pain Med.  2025 Oct;25(5):363-367. 10.17245/jdapm.2025.25.5.363.

Beyond fiberoptic: securing the airway in a child with bilateral TMJ ankylosis

• Jindal S
• Gupta D
• Sood N

• KMID: 2572490
• DOI: http://doi.org/10.17245/jdapm.2025.25.5.363

Abstract

Traumatic injury involving the temporomandibular joint during early childhood can progress to temporomandibular joint ankylosis. Securing the airway for corrective surgery in pediatric temporomandibular joint ankylosis is a considerable anesthetic challenge. While fiberoptic intubation is the gold standard for anticipated difficult airways, a pediatric fiberoptic bronchoscope may not be readily available. We present the anesthetic management of an 11-year-old girl with bilateral TMJ ankylosis scheduled for corrective surgery, using Glidescope^Ⓡ assisted nasotracheal intubation as an alternative in the absence of a pediatric fiberoptic bronchoscope. This case demonstrates that innovative airway management strategies, including the use of a feeding tube guide, can be effectively employed in challenging situations.

Keyword

Ankylosis; Airway Management, Difficult; Child; Temporomandibular Joint