sitting nasal intubation with fiberoptic in an elective mandible surgery under general anesthesia

Introduction:patients with mandible deformity may die, as a result of airway management failures. the awake nasal fiberoptic intubation is known as the optimum intubation method, in the mentioned patients, although, in several cases, fiberoptic intubation fails. case presentation:the present case discusses a patient with severe deformity of mandible that was admitted for correction with freeflap. the following intubation techniques were used for her airway management, respectively: blind awake nasal intubation, awake oral fiberoptic and awake nasal fiberoptic, which failed all. we therefore decided to perform awake nasal intubation, with fiberoptic, in sitting position. conclusions:in this case, after failure of awake fiberoptic intubation, awake direct laryngoscopy and blind nasal intubation, finally awake nasal intubation in sitting position, using fiberoptic led to success.