Airway management in an infant with congenital trismus: the role of retrograde intubation

Abstract

Congenital trismus is a serious anomaly, and establishment of an airway for surgical correction is a challenge. In the case of limited mouth opening, the nasal route is the only available option to secure the airway via the supraglottic route. Various airway management options include blind intubation, retrograde intubation and fibre-optic intubation, failing which a tracheostomy might be needed. We present the airway management of a seven-month-old infant with congenital trismus who was scheduled for corrective surgery. After several unsuccessful attempts at blind nasal intubation, with the infant on spontaneous ventilation, breathing sevoflurane in oxygen, we managed to secure the airway successfully by retrograde intubation.